Nausea and Vomiting During Pregnancy
Nausea with or without vomiting is a very common pregnancy symptom. Despite this condition’s most popular name, “morning sickness,” these symptoms can arise at any time of the day. In addition, while nausea and vomiting most often correlate with the first trimester, women can experience these symptoms throughout the entirety of their pregnancies.
BEST PRACTICES FOR SYMPTOM RELIEF
Meals/snacks in small portions every 2-3 hours to avoid an empty or full stomach
Avoid coffee and spicy or high-fat foods; Incorporate bland, dry, salty and protein-rich foods (soda crackers, dry toast)
Fluids in small quantities and through a straw (cold/clear/carbonated)
Avoid iron-containing supplements until nausea has improved; Talk to your OB about stopping prenatal vitamins if they’re difficult to tolerate (but make sure to continue taking a folic acid supplement (400 micrograms) daily).
Acupressure wristbands
Ginger lollipops, ginger tea, or ginger supplements to combat mild nausea
MEDICATION OPTIONS
First-Line Therapy:
Pyridoxine (Vitamin B6): Take 10-25 mg 3-4 times per day (do not exceed 200 mg per day)
Add Unisom (Doxylamine) to Vitamin B6: Take 10 mg of Unisom at night (may also use 1/2 of a 25 mg tablet); Diclegis is a prescription medication combing Vitamin B6 with unisom and can be used as an alternative to the combination of Pyridoxine and Unisom.
*Benadryl may also be combined with these medications. Orally take 25 mg every 4-6 hours. Keep in mind that Benadryl can cause drowsiness.
Second-Line Therapy: (Try one at a time)
Phenergan: 12.5-25 mg PO or rectally every 6 hours as needed for nausea
Reglan: 10 mg every 6-8 hours (ideally 30 minutes prior to meals and at bedtime)
Ondansetron (Zofran): 4 mg orally every 8 hours as needed for nausea. **It is important to note, older studies showed a possible increase in the risk of cleft palates and heart defects with this medication, but recent studies are inconclusive.
Additional Medications You May Add:
Acid Reducing Agents (Choose One - Do NOT Combine):
Famotidine (Pepcid): As directed (over the counter)
Lansoprazole: 30 mg daily
DEHYDRATION AND ELECTROLYTE ABNORMALITIES
If you experience dehydration or electrolyte abnormalities from your nausea and vomiting, come in for an appointment. Some cases require hospital admission or a visit to the infusion center for IV fluids.