The cause of morning sickness remains a mystery, but it is thought a combination of physical and metabolic factors play a significant role, including:

• High levels of hormones, including oestrogen

• Fluctuations in blood pressure, particularly lowered blood pressure

• Altered metabolism of carbohydrates

• The enormous physical and chemical changes that pregnancy triggers.

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LIFESTYLE MANAGEMENT

Dietary and lifestyle changes are encouraged.

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FOOD

Avoid any foods which may aggravate symptoms (Strong smelling, fatty or fried or acidic etc)

Maintain smaller portions of food throughout the day rather than eating fewer but larger meals. An empty stomach tends to trigger nausea.

Foods should be rich in carbohydrates and low in fat and acid. Baked potatoes, rice, and dry toast are often suitable options.

Eat a few dry crackers or plain biscuits before getting out of bed in the morning.​

Consider seeing a Dietitian

Suitable multivitamin supplementation if poor intake persists; under the direction of your doctor.

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GINGER

Short term use of ginger (<1000mg daily) for the treatment of nausea and vomiting may be helpful. Ginger tablets can be purchased from your pharmacy.

Add a slice of raw ginger or powdered ginger to water or tea.

Sip Ginger cordial or Non-alcoholic ginger beer / ale

Chew or suck on crystallised ginger

Snacks such as gingerbread, or ginger snap cookies may also help.​

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FLUID

Ensure adequate oral fluid intake to prevent dehydration

Drink small quantities throughout the day instead of large volumes less frequently

Sometimes sips of flat lemonade, diluted fruit juice, cordial, weak tea, ginger tea, jelly, clear soup are helpful. If none of these are bearable, try sucking on ice cubes.

Pregnant women ideally require >2.3 litres (about 9 cups) per day.

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SLEEP​

Get good sleep. Sleep requirement increases in early pregnancy and fatigue exacerbates nausea and vomiting of pregnancy.

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CLOTHING

Wear loose and comfortable clothing

Laying is a great idea too

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ACCUPRESSURE

P6 (Nei Guan) acupressure – using wristbands e.g. SeaBand® (some evidence of efficacy)​

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MENTAL HEALTH & WELLBEING

Nausea & Vomitting in pregnancy can affect your Quality of Life.

If it is getting you down, make sure you speak to your doctor for additional support and a management plan for your nausea.

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MEDICATION OPTIONS

Consult your doctor first prior to commencing any medications to discuss benefits, risks & side-effects.

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Available over the counter from the pharmacy.

1.   Pyridoxine B6                                      25 mg orally, in the morning and at midday, and at night. 

2.   Doxylamine (Restavit®)                        25 mg orally, at night.

                                                                                 Increase as tolerated to 12.5 mg in the morning & midday, and 25 mg at night. 

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Prescription medications (under supervision of your doctor).

3.   Metoclopramide (Maxolon®, Pramin®)  10mg orally three times a day

4.   Prochlorperazine (Stemetil®)                   5 to 10mg orally two to three times a day

5.   Promethazine (Phenergan®)                10 to 25mg orally three to four times a day

6.   Ondansetron (Zofran®)                         4mg to 8mg orally (tablet or wafer) two or three times a day

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SEE YOUR DOCTOR IF

Always seek medical advice if your morning sickness is severe

- Signs of Dehydration

- Dark Urine

- Limited oral intake

- Persistent vomiting & not keeping anything down!

- Loosing weight quickly

- You feel depressed

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HYPEREMESIS GRAVIDARUM

Severe morning sickness is known as hyperemesis gravidarum (HG), and can affect around one in 1,000 pregnant women.

The symptoms of HG include repeated vomiting, weight loss and dehydration.

Treatment usually involves hospitalisation, and the administering of intravenous liquids and nutrition.
The possible complications of untreated hyperemesis gravidarum include:

• Electrolyte imbalances

• Extreme depression and anxiety

• Malnourishment of the fetus

• Excessive strain on vital organs, including the liver, heart, kidneys and brain.

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Adapted from

The Royal Women's Hospital "Clinical Guidelines"

Better Health Channel Resources - Fluids and Morning Sickness