Nausea and vomiting of pregnancy (NVP), often referred to as “morning sickness,” is a common condition. It typically begins around the fifth or sixth week and often subsides by the end of the first trimester, though symptoms can persist. NVP can range from mild discomfort to a debilitating condition. Safety for both the pregnant individual and the developing fetus is the primary concern when considering relief options.
Non-Pharmacological Strategies
Non-medication approaches often manage mild to moderate nausea during pregnancy. Eating small, frequent meals prevents an empty stomach, which can trigger nausea. Avoiding trigger foods (spicy, fatty, strong odors) and opting for bland foods like crackers, toast, and rice can provide relief. Staying hydrated by sipping water or clear broths between meals is also important.
Lifestyle adjustments also support comfort. Adequate rest and avoiding sudden movements, especially upon waking, can help mitigate nausea. Fresh air and avoiding strong smells can also help. Ginger (ale, tea, or candies) has been traditionally used and may offer relief. Acupressure, using wristbands at the P6 (Neiguan) point, can also be helpful.
Over-the-Counter Anti-Nausea Options
For persistent nausea, certain over-the-counter (OTC) options are generally considered safe, but consulting a healthcare provider is always recommended. Vitamin B6 (pyridoxine) is a common first-line NVP treatment, often recommended in dosages of 10 to 25 milligrams, three to four times daily.
Doxylamine, an antihistamine that can induce drowsiness, is another OTC option. It is frequently combined with Vitamin B6 to enhance anti-nausea effects. While OTC, its combination with Vitamin B6 is also available as a prescription medication specifically for NVP. Antacids, particularly calcium carbonate-based ones, may also be considered for occasional use if heartburn or indigestion accompanies nausea, as these can exacerbate discomfort.
Prescription Anti-Nausea Medications
If non-pharmacological and OTC options fail to control severe or persistent NVP, a healthcare provider may prescribe medication. Diclegis, a combination of doxylamine and pyridoxine (Vitamin B6), is the only FDA-approved medication specifically for NVP. It holds Pregnancy Category A status, indicating no increased fetal risk based on controlled studies.
Other prescription medications may be used off-label when medically necessary, meaning they are approved for other conditions but have a history of safe use in pregnancy. Ondansetron (Zofran) is an antiemetic prescribed for severe NVP. While effective, it can cause constipation. Promethazine (Phenergan), an antihistamine with antiemetic properties, may also be used, though it often causes drowsiness. These medications require strict medical supervision, with a healthcare provider weighing benefits against risks.
When to Consult a Healthcare Provider
Professional medical attention for nausea and vomiting is warranted beyond self-management or common remedies in certain situations. Consult a healthcare provider if unable to keep down food or fluids for over 24 hours. Other warning signs include significant weight loss or signs of dehydration (reduced urination, dizziness, very dry mouth).
Severe abdominal pain, fever, or vomiting blood also require immediate medical evaluation. Seek medical guidance if persistent nausea and vomiting severely impact quality of life or prevent normal daily activities. Severe nausea and vomiting can indicate hyperemesis gravidarum, a more serious condition often requiring medical intervention, including intravenous fluids and medication, to manage symptoms and prevent complications. This information provides general guidance and does not replace personalized medical advice.