Morning Sickness

What is morning sickness?

Morning sickness is nausea and vomiting during pregnancy. It’s a common condition affecting up to 70% of women in the first trimester of pregnancy (the first three months). Despite its name, “morning” sickness can happen at any time of the day. There are various at-home treatments for morning sickness, including diet and lifestyle changes. Some obstetricians recommend over-the-counter (OTC) medications for nausea. Symptoms tend to improve by the second trimester (beginning at 14 weeks).

How soon can morning sickness start?

It starts as early as the sixth week of pregnancy, but the exact timing varies. Most women experience signs of morning sickness before nine weeks of pregnancy.

When does morning sickness peak?

Morning sickness feels the worst for most women around eight to 10 weeks of pregnancy. However, this time varies, and not everyone’s symptoms “peak” at the same time.

How long does morning sickness last?

Morning sickness tends to improve or go away around the 13th week of pregnancy (the end of the first trimester). However, some women experience lingering symptoms through the beginning of the second trimester (weeks 14 to 27 in pregnancy). In rare cases, morning sickness occurs until the end of your pregnancy.

What are symptoms of morning sickness?

Common signs and symptoms of morning sickness include an upset stomach (nausea), loss of appetite and vomiting. Some women describe morning sickness as feeling like:

• Heartburn or reflux.
• Seasickness or motion sickness.
• Something is stuck in their throat.
• Hunger pangs.

What causes morning sickness?

The cause of morning sickness isn’t entirely known, but healthcare providers believe it’s a mix of physical and chemical changes. It may be caused by:

• Low blood sugar.
• An increase in pregnancy hormones like human chorionic gonadotropin (HCG) or estrogen.
• Blood pressure fluctuations.
• Changes in metabolism.

Morning sickness may be worsened by:

• Stress and anxiety.
• Being overtired.
• Eating or smelling certain foods.
• Motion sickness.
• Heat or warm weather.

Can morning sickness become severe?

Yes. Most women with morning sickness feel nauseous for a short time each day and may vomit once or twice. In more severe cases of morning sickness, nausea can last several hours each day and vomiting occurs more than four times per day. This is a condition called hyperemesis gravidarum.

What are the symptoms of hyperemesis gravidarum?

Symptoms of hyperemesis gravidarum include:

• Vomiting more than three times a day.
• Becoming severely dehydrated (signs of which include little to no urine production, dark-colored urine and dizziness with standing).
• Losing 10 pounds (around 4.5 kilograms) or more.

Women with severe morning sickness may need to be admitted to the hospital to receive IV fluids to restore hydration and medications to relieve nausea.

How is morning sickness diagnosed?

Tell your obstetrician if you feel symptoms of morning sickness. If they suspect hyperemesis gravidarum, they may order urine (pee) or blood tests.

What can I do to reduce morning sickness?

There are a few things you can do to feel better. Making small changes to your diet and lifestyle can go a long way in decreasing nausea.

Diet changes for morning sickness

• Eat a few crackers or toast in the morning to help settle your stomach. Keep a few crackers next to your bed and eat a couple before getting up.
• Eat several small meals a day instead of three large meals. Don’t skip meals.
• Avoid spicy and fatty foods. Eat bland foods such as bananas, rice, dry toast, plain baked potato, gelatin, broth, eggs, or applesauce.
• Eat nutritious, protein-rich snacks between meals, such as yogurt, peanut butter on apple slices or celery, cheese or nuts.
• Drink plenty of fluids, especially water, throughout the day. Avoid caffeinated beverages.
• Always carry a bag of snacks with you when you’re away from home.
• Make tea with real grated ginger or try ginger candies.

Lifestyle changes for morning sickness

• Take your prenatal vitamins with a snack. If your prenatal vitamin contains iron, try taking it at bedtime. Talk with your doctor about other vitamin options.
• Avoid odors, flickering lights and other situations that bother you and trigger your nausea.
• Get plenty of rest.
• Keep rooms well-ventilated, turn on a fan or go outside from time to time to get some fresh air.
• Smell fresh, pleasant scents such as lemon, orange or mint.
• Don’t lie down after eating.
• Rinse your mouth after you vomit. This can help protect your teeth from the acid contained in your vomit.

Alternative methods for nausea during pregnancy

Other methods may help reduce nausea. Talk with your healthcare provider before trying these:

• Acupressure wristband: These bands apply pressure to specific points on the wrist.
• Acupuncture: Thin needles are placed in certain areas of your skin during acupuncture treatment.

Don’t use marijuana to treat morning sickness. It hasn’t been proven to be safe during pregnancy.

What foods are good for morning sickness?

Eating a diet high in protein, whole grains, vegetables and fruit is beneficial for you and for the fetus. Eating foods that are highly processed and full of sugar may make you feel worse. Healthcare providers often recommend the following foods to women suffering from morning sickness:

• Bland foods like crackers, toast, pretzels or applesauce.
• Fruit smoothies and yogurt.
• Water or tea (watch the caffeine levels in tea).
• Fruits and veggies like watermelon, celery or bell peppers that are high in water. Citrus fruits may also help with nausea.

What medications are available to treat morning sickness?

Your healthcare provider may recommend taking vitamin B6 (also called pyridoxine) and doxylamine. Doxylamine is also used as a sleep aid and to treat hay fever or other allergies. Both products are available over-the-counter and don’t need a prescription.

There’s a medication approved for morning sickness called Diclegis®. Unlike the separate over-the-counter products, Diclegis® is a slow-release single pill. This may be more convenient or helpful for people who have trouble (for example, have a gag reflex) taking many pills per day. It’s available by prescription only.

Your obstetrician can prescribe medications to prevent nausea (also called antiemetics). If these drugs don’t help, other drugs like antihistamines and anticholinergics may work. You and your healthcare provider will decide which medications work best for you.

Does morning sickness harm my baby?

Mild to moderate nausea and vomiting during pregnancy usually isn’t harmful to you or the fetus. However, it can become a problem if you can’t keep food or liquid down, become dehydrated and lose weight. Unmanaged severe nausea and vomiting can prevent you from getting the nutrition you need and affect your baby’s weight at birth.

Are some women more at risk for developing severe morning sickness?

Yes. The risk for severe morning sickness increases if you:

• Are pregnant with twins, triplets or more.
• Have a personal history of severe morning sickness with a previous pregnancy and/or have a biological parent or sibling who had a history of severe morning sickness with pregnancy.
• Have a history of motion sickness.
• Have a history of migraines.
• Have overweight (a body mass index, or BMI, greater than 25 and less than 30).
• Have a condition called trophoblastic disease, which leads to abnormal cell growth in the uterus.
• Are stressed or anxious.
• Live in a hot climate.
• Work night shifts.
• Are sleep-deprived.

Some studies have shown that women with severe morning sickness are more likely to give birth to girls.

When do I need to call my doctor?

Don’t wait until vomiting becomes severe to call your obstetrician. Seeking care for morning sickness early in pregnancy can help prevent it from becoming more severe. Severe vomiting isn’t a normal aspect of pregnancy and requires medical care.

Call your healthcare provider right away if you:

• Have nausea that lasts all day long and keeps you from eating and drinking.
• Vomit three or more times a day.
• Have vomit that’s brown or has blood in it.
• Lose weight.
• Feel extremely tired or confused.
• Feel dizzy or have fainted.
• Have a fast heartbeat.
• Produce little to no pee.
• Have pain or a fever.

Another reason to investigate severe nausea and vomiting is that it may be a symptom of other medical conditions, including:

• Ulcers.
• Reflux (heartburn).
• Food-related illness.
• Thyroid or gallbladder disease.
• Inflammation of the appendix, stomach, pancreas or liver.

Is morning sickness a good sign?

Some women believe morning sickness is a good sign because it means the placenta is developing. They also feel reassured that they’re pregnant. In reality, not everyone gets morning sickness. If you never have morning sickness, you’re just as likely to give birth to a healthy baby as someone who does get morning sickness.

A note from Cleveland Clinic

Morning sickness can make pregnancy seem pretty awful and uncomfortable. It’s extremely common to feel nauseous and queasy, especially during the first trimester of pregnancy. Luckily, most women find that morning sickness subsides once they begin their second trimester. Changes in your lifestyle and eating habits may bring some relief until the symptoms go away. Let your obstetrician know if you’re throwing up several times per day, not eating and losing weight. They’ll want to make sure you’re getting the nourishment you need.