Diagnosis

Morning sickness is typically diagnosed based on your signs and symptoms. If your health care provider suspects hyperemesis gravidarum, you may need a clinical exam and various urine and blood tests.

Treatment

If your morning sickness symptoms persist, your health care provider may recommend vitamin B-6 supplements (pyridoxine), ginger and over- the-counter options such as doxylamine (Unisom) for management. If you still have symptoms, your health care provider may recommend prescription anti-nausea medications.

Moderate to severe nausea and vomiting of pregnancy may cause dehydration and electrolyte, such as sodium or potassium, imbalance. Extra fluids and prescription medications are recommended for moderate to severe morning sickness.

Your doctor will talk about how often you have nausea, how many times you have vomited, whether you can keep down fluids, and whether you have tried home remedies. There are a number of prescription medications that are safe to take during pregnancy for nausea and vomiting. Your doctor will recommend a safe option, based on the severity of your symptoms.

Check with your doctor before taking any over-the-counter medications or supplements during pregnancy.

If you have hyperemesis gravidarum, you may need to be treated with intravenous (IV) fluids and anti-nausea medications in the hospital.

Lifestyle and home remedies

To help relieve morning sickness:

  • Choose foods carefully. Select foods that are high in protein, low in fat and easy to digest, and avoid greasy, spicy and fatty foods. Bland foods, such as bananas, rice, applesauce and toast may be easy to digest. Salty foods are sometimes helpful, as are foods that contain ginger — such as ginger lollipops.
  • Snack often. Before getting out of bed in the morning, eat a few soda crackers or a piece of dry toast. Nibble throughout the day, rather than eating three larger meals so that your stomach doesn't get too full. Plus, an empty stomach may make nausea worse.
  • Drink plenty of fluids. Sip water or ginger ale. Aim for six to eight cups of noncaffeinated fluids daily.
  • Pay attention to nausea triggers. Avoid foods or smells that seem to make your nausea worse.
  • Breathe fresh air. Weather permitting, open the windows in your home or workplace. Take a daily walk outdoors.
  • Take care with prenatal vitamins. If you feel queasy after taking prenatal vitamins, take the vitamins with a snack or just before bed. If these steps don't help, ask your health care provider about other ways you can get the iron and vitamins you need during pregnancy.
  • Rinse your mouth after vomiting. The acid from your stomach can damage the enamel on your teeth. If you can, rinse your mouth with a cup of water mixed with a teaspoon of baking soda. This will help neutralize the acid and protect your teeth.

Alternative medicine

Various alternative remedies have been suggested for morning sickness, including:

  • Acupressure. Acupressure wristbands are available without a prescription in most pharmacies. Studies on acupressure wristbands have had mixed results, but some women seem to find the wristbands helpful.
  • Acupuncture. With acupuncture, a trained practitioner inserts hair-thin needles into your skin. Acupuncture isn't a proven way to treat morning sickness, but some women seem to find it helpful.
  • Ginger. Herbal ginger supplements seem to alleviate morning sickness for some women. Most research suggests that ginger can be used safely during pregnancy, but there's some concern that ginger may affect fetal sex hormones.
  • Hypnosis. Although there's little research on the topic, some women have found relief from morning sickness through hypnosis.
  • Aromatherapy. Although there is also little research on the topic, certain scents, normally created using essential oils (aromatherapy), can help some women deal with morning sickness.

Some women might be tempted to try marijuana as a way to ease nausea if they live in a state where it's legal. However, the American College of Obstetricians and Gynecologists warns that pregnant women shouldn't use marijuana because the effects of the drug on mother and baby haven't been well-studied. Additionally, chronic marijuana use may result in a nausea and vomiting syndrome called cannabinoid hyperemesis syndrome.

Check with your health care provider before using any herbal remedies or alternative treatments to relieve morning sickness.

Preparing for your appointment

You can usually wait until a routine prenatal appointment to talk to your doctor about morning sickness.

What you can do

To prepare for your appointment:

  • Write down any symptoms you're experiencing. Include all of your symptoms, even if you don't think they're related.
  • Make a list of any medications, vitamins and other supplements you take. Write down doses and how often you take them.
  • Have a family member or close friend accompany you, if possible. You may be given a lot of information at your visit, and it can be difficult to remember everything.
  • Take a notebook or notepad with you. Use it to write down important information during your visit.
  • Think about what questions you'll ask. Write them down, listing the most important questions first.

Some basic questions to ask about morning sickness include:

  • Is pregnancy causing my symptoms or could it be something else?
  • Do I need any tests?
  • Will I have nausea and vomiting throughout my entire pregnancy?
  • Are there any medications I can take to help with my symptoms?
  • Does morning sickness pose any risk to my baby?
  • What can I eat or drink to help my queasiness?

Don't hesitate to ask follow-up questions as they occur to you during your appointment.

What to expect from your doctor

Some potential questions your health care provider might ask include:

  • How long have you had symptoms?
  • How often do you experience bouts of nausea or vomiting?
  • How severe are your symptoms? Are you able to keep food down?
  • Do you notice certain triggers for your nausea or vomiting?
  • Do you experience your symptoms at certain times during the day or all the time?
  • Are you taking a prenatal vitamin? Do you regularly take any other medications?
  • Does anything make you feel better?
  • What, if anything, makes you feel worse?
Sept. 22, 2018
References
  1. American College of Obstetricians and Gynecologists (ACOG) Committee on Practice Bulletins — Obstetrics. ACOG Practice Bulletin No. 189: Nausea and vomiting of pregnancy. Obstetrics & Gynecology, 2018;131:e15.
  2. Frequently asked questions. Pregnancy FAQ126. Morning sickness: Nausea and vomiting of pregnancy. American College of Obstetricians and Gynecologists. https://www.acog.org/Patients/FAQs/Morning-Sickness-Nausea-and-Vomiting-of-Pregnancy. Accessed July 9, 2018.
  3. Boeling RC, et al. Interventions for treating hyperemesis gravidarum. Cochrane Database of Systematic Reviews. http://www.thecochranelibrary.com. Accessed July 9, 2018.
  4. Refruezo JS, et al. Clinical features and evaluation of nausea and vomiting of pregnancy. https://www.uptodate.com/contents/search. Accessed Aug. 19, 2018.
  5. AskMayoExpert. Nausea and vomiting in pregnancy. Rochester, Minn.: Mayo Foundation for Medical Education and Research; 2018.
  6. Vitamin B-6. Office of Dietary Supplements. https://ods.od.nih.gov/factsheets/VitaminB6-HealthProfessional/. Accessed July 9, 2018.
  7. Smith JA, et al. Treatment and outcomes of nausea and vomiting of pregnancy. https://www.uptodate.com/contents/search. Accessed Aug. 19, 2018.
  8. Natural medicines used during pregnancy and lactation. Natural Medicines. https://naturalmedicines.therapeuticresearch.com. Accessed Aug. 19, 2018.
  9. Adlan AS, et al. Acupressure as adjuvant treatment for the inpatient management of nausea and vomiting in early pregnancy: A double-blind randomized controlled trial. The Journal of Obstetrics and Gynaecology Research. 2017;43:662.
  10. American College of Obstetricians and Gynecologists (ACOG) Committee on Obstetric Practice. Committee Opinion No. 722: Marijuana use during pregnancy and lactation. Obstetrics & Gynecology. 2017;130:931.
  11. Butler Tobah YS (expert opinion). Mayo Clinic, Rochester, Minn. Aug. 24, 2018.
  12. Galli JA, et al. Cannabinoid hyperemesis syndrome. Current Drug Abuse Review. 2011;4:241.