Morning Sickness
Morning sickness, also called nausea gravidarum, nausea, vomiting of pregnancy(emesis gravidarum or NVP), or pregnancy sickness is a condition that affects more than half of all pregnant women. Related to increased estrogen levels, a similar form of nausea is also seen in some women who use hormonal contraception or hormone replacement therapy. Sometimes it is present in the early hours of the morning and reduces as the day progresses. The nausea can be mild or induce actual vomiting, however, not severe enough to cause metabolic derangement. In more severe cases, vomiting may cause dehydration, weight loss, alkalosis and hypokalemia. This condition is known as hyperemesis gravidarum and occurs in about 1% of all pregnancies. Nausea and vomiting can be one of the first signs of pregnancy and usually begins around the 6th week of pregnancy (counting gestational age from 14 days before conception). In spite of its common name, it can occur at any time of the day, and for most women it may stop around the 12th week of pregnancy. Morning sickness is currently believed to be an evolved trait that protects the fetus against toxins ingested by the mother. Many plants contain chemical toxins that serve as a deterrent to being eaten. Adult humans, like other animals, have defenses against plant toxins, including extensive arrays of detoxification enzymes manufactured by the liver and the surface tissues of various other organs. In the fetus, these defenses are not yet fully developed, and even small doses of plant toxins that have negligible effects on the adult can be harmful or lethal to the embryo. Pregnancy sickness causes women to experience nausea when exposed to the smell or taste of foods that are likely to contain toxins injurious to the fetus, even though they may be harmless to her. There is considerable evidence in support of this theory, including:
In addition to protecting the fetus, morning sickness may also protect the mother. Pregnant women's immune systems are suppressed during pregnancy, it is presumed to reduce the chances of rejecting tissues of their own offspring. Because of this, animal products containing parasites and harmful bacteria can be especially dangerous to pregnant women. There is evidence that morning sickness is often triggered by animal products including meat and fish.
If morning sickness is a defense mechanism against the ingestion of toxins, the prescribing of anti-nausea medication to pregnant women may have the undesired side effect of causing birth defects or miscarriages by encouraging harmful dietary choices. On the other hand, many domestic vegetables have been purposely bred to have lower levels of toxins than in the distant past, and so the level of threat to the embryo may not be as high as it was when the defense mechanism first evolved.
Treatment
There is no evidence to demonstrate the effectiveness of treatments for morning sickness. Suggested treatments typically aim to lessen the symptoms of nausea, rather than attacking the root cause(s) of the nausea. Frequently suggested treatments include:
ThalidomideFurther information: ThalidomideThalidomide was originally developed and prescribed as a cure for morning sickness in West Germany, but its use was discontinued when it was found to cause birth defects. The United States Food and Drug Administration never approved thalidomide for use as a cure for morning sickness.
o Due to HCG levels
o Crackers 30 min before arising
o AM – Carb diet 30 mins
o PM – small frequent meal
- Morning sickness is very common among pregnant women, which argues in favor of its being a functional adaptation and against the idea that it is a pathology.
- Fetal vulnerability to toxins peaks at around 3 months, which is also the time of peak susceptibility to morning sickness.
- There is a good correlation between toxin concentrations in foods, and the tastes and odors that cause revulsion.
In addition to protecting the fetus, morning sickness may also protect the mother. Pregnant women's immune systems are suppressed during pregnancy, it is presumed to reduce the chances of rejecting tissues of their own offspring. Because of this, animal products containing parasites and harmful bacteria can be especially dangerous to pregnant women. There is evidence that morning sickness is often triggered by animal products including meat and fish.
If morning sickness is a defense mechanism against the ingestion of toxins, the prescribing of anti-nausea medication to pregnant women may have the undesired side effect of causing birth defects or miscarriages by encouraging harmful dietary choices. On the other hand, many domestic vegetables have been purposely bred to have lower levels of toxins than in the distant past, and so the level of threat to the embryo may not be as high as it was when the defense mechanism first evolved.
Treatment
There is no evidence to demonstrate the effectiveness of treatments for morning sickness. Suggested treatments typically aim to lessen the symptoms of nausea, rather than attacking the root cause(s) of the nausea. Frequently suggested treatments include:
- If the vomiting/nausea is due to acid reflux, taking an antacid or two before bed may help reduce the stomach acid and prevent morning vomiting.
- If the vomiting/nausea is due to reduced stomach motility then reducing fibre and fat intake may help. (For example, white bread instead of brown bread, well cooked fruits and vegetables instead of raw, avoiding high-fiber foods, removing skins from fruit or vegetables, avoiding fatty meats and high-fat foods.) Also, walking after meals may help to increase stomach motility.
- If the vomiting/nausea is due to acid reflux or reduced stomach motility, eating more small meals during the day (instead of several larger ones) may help. This will also help to keep blood sugar levels more consistent.
- If the vomiting/nausea is due to iron pills (or multivitamins containing iron) a slower-release form or several lower-dose iron pills may help.
- If the vomiting/nausea is due to low blood sugar, avoiding an empty stomach may help (e.g. snacking throughout the day with several smaller meals instead of a few large ones.)
- Folk remedy: Lemons, in particular the smelling of freshly cut lemons.
- Accommodating food cravings and aversions.
- Eating cabbage.
- Ginger, in capsules, tea, ginger ale, or ginger snaps. Safety concerns have been raised in the medical community due to the powerful pharmacological activity of ginger, especially its anticoagulant action.
- Eating dry crackers in the morning. Some women benefit from eating crackers before rising out of bed in the morning. This may be because it helps to absorb the stomach acid.
- Drinking liquids 30 to 45 minutes after eating solid food.
- If liquids are vomited, sucking ice cubes made from water or fruit juice or trying lollipops.
- Wearing acupressure wristbands to stimulate the "Nei-Kuan" acupuncture point on your wrist.
ThalidomideFurther information: ThalidomideThalidomide was originally developed and prescribed as a cure for morning sickness in West Germany, but its use was discontinued when it was found to cause birth defects. The United States Food and Drug Administration never approved thalidomide for use as a cure for morning sickness.
o Due to HCG levels
o Crackers 30 min before arising
o AM – Carb diet 30 mins
o PM – small frequent meal