How To Deal with Severe Nausea and Vomiting During Pregnancy?

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Hyperemesis gravidarum (HG) is a rare disorder that occurs during pregnancy, characterized by severe nausea and vomiting. This condition may cause dizziness and light-headedness, and result in weight loss and dehydration.

Lifestyle

A. Diet (what you can eat)

Most women with HG cannot stomach any food, and often end up dehydrated and lacking vitamins. Here are some recommendations on how to keep the food down:

  • Eat a small meal/ snack every 2 hours instead of 3 large meals
  • Eat a small snack before going to sleep/ eat crackers or dry toast before getting out of bed if nauseous
  • Eat a bland diet
    • Avoid foods with high fat content/ rich flavours/ spicy foods
    • Eat cold and dry foods (e.g. cereal, crackers, toast)
  • Eat slowly
  • Avoid sensory stimulation that may trigger your nausea (e.g. smells, noises)
  • Drink lots of water
    • Try to drink at least 8 glasses of liquids every day
    • 100% fruit juice/ lemonade may help with nausea
    • Avoid alcohol/ drinks that contain caffeine

B. Rest

Lying down on your bed may help to ease the pain/ bring some comfort, especially after eating. However, lying down for prolonged periods of time may cause muscle and weight loss. Too much rest may also result in longer recovery periods after delivery. Try to walk around/ exercise to prevent your condition from worsening.

Medications

A. Antiemetics

These are drugs that help to relieve morning sickness, usually only prescribed for severe nausea and vomiting. Some antiemetics include:

  • Pyridoxine (vitamin B6)
  • Prochlorperazine
  • Metoclopramide

Although these drugs can help pregnant women manage their morning sickness, they can also result in some side effects, which include:

  • Constipation
  • Diarrhea
  • Headache
  • Fatigue
  • Dizziness/ light-headedness
  • Dry mouth

B. Steroids

Prednisolone is commonly used to treat HG, by reducing the frequency of continuous/ high-frequency vomiting. It is taken as a pill, and has been shown to have no effect on the baby because it becomes inactive in the placenta. As such, it is safer to use during pregnancy.

However, taking prednisolone can lead to some side effects, including:

  • Insomnia
  • Weight gain
  • Indigestion
  • Excessive sweating

Admission to hospitals

For some severe cases of HG, women have to be admitted to the hospital so that their body has the necessary fluids, vitamins and foods necessary to take care of the baby and herself.

A. Intravenous (IV) fluids

Having an IV drip allows you to have a continuous supply of fluids, avoiding the cycle of dehydration and rehydration. Scheduled IV fluids can provide you with the necessary nutrients, vitamins and electrolytes. However, the IV should not be left in the body for more than a week to prevent infection and other complications.

B. Tube feeding

For the most serious cases, tube feeding may be used to provide you with nutrients:

  • Nasogastric
    • Foods are given via a tube that goes through the nose and into the stomach
    • This ensures that the stomach and intestines are still being utilised to digest the food
    • Typically used for short-term tube feeding
  • Percutaneous endoscopic gastrostomy
    • Foods are given via a tube that passes through the abdomen and goes straight into the stomach
    • A surgery is required to insert the tube
    • Typically used for long-term tube feeding

Some side effects include:

  • Abdominal pain/ cramp/ swelling
  • Diarrhea
  • Nausea/ vomiting
  • Can cause ulcers in your throat/ esophagus/ stomach if used for too long (for nasogastric)
  • Wound infection (for percutaneous endoscopic gastronomy)

Other treatment methods:

A. Acupuncture

Acupuncture at certain pressure points may help to reduce nausea. One common pressure point (Nei guan/ P6) is located at your inner wrist, 3 fingers away from your palm.

By pressing on this point for 2 to 3 minutes with your thumb, your nausea may be reduced. Rotate your thumb in circles when pressing down, and do not push too hard. Repeat the same process for the other wrist.

If necessary, an acupuncture practitioner may be hired to help reduce nausea.

B. Counselling

For women suffering from HG, counselling can provide a safe and supportive environment for them to express their feelings and troubles about their pregnancy. Being acknowledged and understood can show them that they are not alone and help to enhance their emotional well-being. Through counselling, they can also learn some coping strategies to manage HG better.

Counselling can be carried out during pregnancy, or after pregnancy to help women cope with the trauma caused by HG.

If you or a loved one is dealing with nausea and vomiting during pregnancy, don’t hesitate to reach out for help. The first step is always talking to your doctor to rule out any serious underlying causes. From there, you can try some of the home remedies and lifestyle changes we’ve detailed above. And remember, you’re not alone – up to 80% of pregnant women will deal with this issue at some point during their pregnancies.

If you have any other tips, please share them in the comments! And if you know anyone else who is dealing with severe nausea and vomiting, please share this post with them.