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Morning sickness
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“Morning sickness” can occur at any time of the day. The cause is unknown although it has been linked to changes in the levels of various hormones during pregnancy. It usually starts at about the sixth week of pregnancy and settles by about the fourteenth week. Some women will not be affected by morning sickness, but in others it can be severe enough to require hospitalisation.
Fortunately, your baby is not likely to suffer because you are unwell unless your symptoms are severe and prolonged. If however, you were not eating well before pregnancy, have lost a lot of weight quickly, are dehydrated or worried, check with your doctor or ring the hospital for advice.
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What can I do to help?
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Drink enough to prevent dehydration
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It is important to drink plenty of fluids as dehydration makes nausea and vomiting worse.
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- Drink small amounts often.
- Sometimes other fluids are managed better than water. Try flat lemonade, Lucozade, sports drinks such as Gatorade, diluted fruit juice, cordial, weak tea, clear soup or Bonox/Bovril.
- Suck on ice or icy poles if other fluids cannot be managed.
- Some people find ginger helps relieve nausea. Try dry ginger ale or ginger tea. To make ginger tea, soak three or four slices of ginger in boiling water for five minutes. Sip slowly. Ginger tablets are also available from your local pharmacy.
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Suggestions to reduce the severity of your symptoms
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- Eat small amounts of food more often, rather than large meals.
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- Avoid having an empty stomach. Snack in between mealtimes, e.g. biscuits, fruit, toast.
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- Early morning nausea may be helped by eating a dry or plain sweet biscuit before getting out of bed or by snacking during the night if you wake up.
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- Salty foods may help. Try potato crisps or salty biscuits.
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- Try sucking on barley sugar or boiled sweets.
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- Avoid fatty, rich or spicy foods like takeaways, curries, hot chips, chocolate.
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- Make the most of your best time of the day – eat well when you feel best or whenever you feel hungry during the day.
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- If the smell of hot food makes you feel ill – try eating cold food instead. If possible, avoid cooking and ask for help from friends and relatives.
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- Choose simple dishes that are quick and easy to prepare. If you spend too much time preparing food you may not feel like eating.
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Some foods to try
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- Dry or plain sweet biscuits
- Toast with honey or jam
- Sandwiches with low fat fillings such as tomato, salad, vegemite
- Low fat soups
- Fresh or stewed fruit
- Ice cream, custard or yoghurt
- Grilled, lean meat
- Steamed chicken
- Baked or grilled fish
- Boiled or scrambled eggs
- Boiled rice
- Mashed potato.
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Hyperemesis
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A small percentage of women suffer from excessive and prolonged vomiting, called “hyperemesis”. If left untreated, hyperemesis can lead to dehydration. It is important to see your doctor if symptoms are severe.
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How is hyperemesis treated?
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- There is a range of medications of varying strengths which help to relieve severe symptoms. Make sure you take your medication regularly, as prescribed, or it will not be effective.
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- If you are unable to drink enough fluid, you may need to attend your hospital for regular intravenous fluids. This may be recommended two to three times per week.
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- Drink as much as you can to keep hydrated and eat whatever you can tolerate.
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- As symptoms settle, gradually get back to healthy eating. This is important to replace the nutrients you have been missing out on. Your dietitian may also recommend a multivitamin supplement.
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What about weight loss?
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It is not uncommon to lose weight whilst you are unwell. A small amount of weight loss is unlikely to harm your baby. For prolonged vomiting with continued weight loss, seek further advice from your doctor. Also, your dietitian may recommend some supplements to help prevent weight loss. Weight can be regained quickly once you begin to eat normally again.
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Gradually increase your intake until you are able to eat a well-balanced diet.
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As your appetite improves, you will be able to manage greater amounts and a wider variety of foods. Aim to eventually choose foods according to the healthy food guide (see table) and drink at least 8 – 10 glasses of fluid each day.
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| | | Bread (preferably multigrain), cereals, rice, pasta, noodles
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| | 1 cup rice, pasta, noodles (cooked)
1 cup cereal
1 to 2 slices bread
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| | 4 to 8
(include both fruit and vegetables)
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| half cup vegetables
1 cup salad
1 medium fruit e.g. apple
2 smaller fruit e.g. plums
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| Meat, chicken, fish, eggs, tofu, legumes ( dried beans, pulses), nuts
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| | 100g meat or chicken (palm sized piece)
150g fish
2 eggs
half cup legumes
half cup tofu
half cup nuts
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| Milk, yogurt, cheese, soy milk with added calcium
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| | 1 cup (250mls) milk or soy milk
1 slice cheese (35g)
1 small carton (200g) yoghurt
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| Extra foods e.g. fats and oils, cakes, biscuits, fried foods, potato chips, soft drinks
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| Have in small amounts or occasionally
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Other important considerations
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There are alternative treatments which some women find useful, e.g. acupuncture or hypnotherapy. Alternative treatments are not routinely offered as part of your maternity service. Your doctor or midwife may be able to provide more information.
Have plenty of rest as nausea is often worse when tired.
Keep stress to a minimum. Ask for help as you need it from family and friends.
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For more information
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Nutrition and Dietetics
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Royal Women's Hospital
Level 1
Cnr Grattan St & Flemington Rd
Parkville VIC 3052
Tel: (03) 8345 3160
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Women's Health Information Centre
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Royal Women's Hospital
Ground floor, left of main entrance
Cnr Grattan St & Flemington Rd
Parkville VIC 3052
Tel: (03) 8345 3045 or 1800 442 007 (rural callers)
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Disclaimer
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The Royal Women’s Hospital does not accept any liability to any person for the information or advice (or use of such information or advice) which is provided in this fact sheet or incorporated into it by reference. We provide this information on the understanding that all persons accessing it take responsibility for assessing its relevance and accuracy. Women are encouraged to discuss their health needs with a health practitioner. If you have concerns about your health, you should seek advice from your health care provider or if you require urgent care you should go to the nearest Emergency Dept.
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Published December 2009. Reviewed January 2012
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