Dear Doctor, I am pregnant with my first child and in my second trimester. I’ve consistently had morning sickness to this day. I can’t seem to keep anything down because most food smells make me nauseous. I’m afraid my baby will be underweight because of my poor eating habits. What can I do to change this? Salmah Dear Salmah, Accept my heartiest congratulations on your first pregnancy. It is indeed a very memorable occasion for any woman to know that she is carrying a baby in her womb. Apart from the pleasure, it carries some problems as well and morning sickness is one of them. “Morning sickness” refers to the nausea and or vomiting which occurs during pregnancy. It may begin from start of pregnancy and is usually the first sign of pregnancy. It may subside by second trimester or continue throughout pregnancy. In some women, it begins by six to eight weeks. The nausea and vomiting may be mild to moderate or may be severe, when the pregnant lady is unable to hold anything eaten or drunk (hyperemesis gravidarum). The exact underlying cause of hyperemesis is not known. But it is presumed to be related to the pregnancy hormone, i.e. HCG (human chorionic gonadotropin). Though it is called “morning sickness” the sickness can occur at any time of the day, including evening. One may have nausea and or vomiting throughout the day. Some women have it in first pregnancy only, whereas others may have it in every pregnancy. A few women may have it in second or third pregnancy, whereas some may not have it at all. Hence, it can be seen that occurrence and pattern of morning sickness is variable from person to person and is unpredictable. Morning sickness makes the individual feeling sick and also affect the nutrition and health of both the mother and unborn baby. Mother may have electrolyte imbalance, resulting in fatigue and muscle cramps. The baby born may be underweight and under nourished. If the morning sickness is tolerable, the pregnant lady should try to take small frequent meals with healthy liquids in between. Easily digested foods like rice, whey, fruits, vegetables, and etcetera, should be taken in place of fatty and very spicy foods. Alcohol, excess of tea and coffee should be avoided. These have adverse effects on the pregnancy outcome and also aggravates morning sickness. If one does not have excess flatulence or allergy to milk, milk taken in small quantity in sips is useful. Use of ginger is also said to be helpful in curing morning sickness. Due attention should be given to see that all nutritional needs are met and fulfilled. Anti-vomiting and antacid drugs are available, which can be taken safely to find relief in nausea and vomiting. If vomiting is too much, there is a risk of dehydration and electrolyte imbalance in the affected person. In such cases, intravenous fluids are necessary. Dr. Rachna Pande is a specialist in internal medicine.
