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A Complete Guide to Holistic Morning Sickness Treatment



Oh, mama, I FEEL YOU! “Morning sickness”, or more accurately, nausea and vomiting in pregnancy (NVP) SUCKS!


NVP affects up to 80% of pregnant women and usually occurs between 5 and 18 weeks of gestation. Hyperemesis gravidarum (HG), extreme nausea and vomiting that can last throughout pregnancy, affects less than 3% of pregnancies, but is very serious.


There are likely many factors that cause some mamas to get NVP, such as quickly rising hormones like HCG, estrogen, and progesterone and gastrointestinal dysmotility, meaning the muscles of your digestive tract are contracting abnormally. The bacteria H. Pylori, which is present in about half of people worldwide, may also be related to a higher incidence of getting HG.

The good news is that first trimester nausea is generally thought to be a sign of healthy pregnancy but that doesn’t mean you have to just suffer. Here are my favorite “quease-easers”:

Diet Modifications

Eat smaller, more frequent meals

NVP is often triggered by blood sugar fluctuations so keeping your blood sugar as stable as possible can help. Many mamas will have crackers on their nightstand so they can nibble on one even before getting out of bed. Having a protein-rich snack may also help keep blood sugars more stable overnight.

Opt for more complex carbs and veggies

When you don’t feel good, the only thing that might sound palatable are simple carbs like crackers, breads, noodles or pasta. But studies have suggested that sugar and processed carbohydrate intake can worsen nausea, where eating some veggies can help ease the severity overall. I suggest trying to eat starchy veggies like yams, parsnips carrots and limit sugary processed foods as much as possible. Cruciferous veggies, like broccoli, cauliflower, brussel sprouts and cabbage will also help promote liver detoxification, which will help process all those hormones.

Eat Protein

One of the underlying causes of NVP is irregular muscle contractions in your digestive system. Studies have shown that eating protein-rich meals helps ease this. Eating protein also helps stabilize your blood sugar.

Avoid spicy, fried, fatty foods

These are some other big triggers for nausea and heartburn during pregnancy due to slowed digestion. Limiting fats temporarily will help ease digestive concerns.

Stay hydrated

Dehydration will definitely make you feel a lot worse. Sipping water with lemon throughout the day will help prevent dehydration and promote digestion and liver detoxification.


Lifestyle Modifications

REST

Mama, that fatigue is your body telling you to rest. Even if you don’t feel anything happening in your belly yet, you’re creating a little human! So unload any responsibilities that you can, ask for help, and slow down temporarily. If you have a kiddo at home already, this is a great time to teach them by example how to listen to their own body.

Mindfulness

Mindfulness-based cognitive therapy has been shown to be beneficial in addition to pyridoxine. Don’t know where to start? I recommend doing some gentle, slow breathing to shift your nervous system out of “fight or flight”. Then try to shift your thoughts to peaceful, positive things like “I’m growing a healthy baby” or “This is temporary. I will get through this and it will be a distant memory”. You can also do some visualization to go to your “happy place” if you need a break. Imagine every beautiful detail of your favorite vacation spot and feel calm and relaxed.


Supplements


Vitamin B6

Vitamin B6, aka pyridoxine, is a water-soluble vitamin involved in the metabolism of amino acids, lipids, and carbohydrates. It has been shown to be effective against nausea in pregnancy. It is also completely safe (pregnancy category A) at doses up to 100mg per day. I recommend taking the Pyridoxyl-5-phosphate (P-5-P) form which is more active. The typical dosage for nausea is 10-25mg three times a day, but could be taken in 50mg doses once or twice a day depending on what works well for you. If you can’t tolerate oral supplements, this can be given through IV infusion or injection.


I recommend starting this supplement once you find out you’re pregnant, or even before! Not only is B6 essential for metabolizing macronutrients and helpful with easing morning sickness, but it may actually help prevent or lessen the overall severity of NVP if taken ahead of time.

Ginger

Taking up to 1,500mg per day of ginger can reduce nausea and is safe in pregnancy. You can take it in capsule form or sip on ginger tea. Instead of sugary ginger ale, try grating fresh ginger into sparkling mineral water and adding a squeeze of lemon or a splash of juice for some natural sweetness.



Other therapies

Acupuncture and acupressure

Acupuncture or acupressure on the Pericardium 6 (P6, Nei Guan) have been shown to ease nausea, vomiting, and retching and is considered safe in pregnancy. I’m a fan of Sea-bands or acupressure magnet stickers, which you can buy online.

Essential oils

Smelling peppermint essential oil may help ease mild nausea, headache, and fatigue. I also like “digestive” essential oils like fennel and ginger to promote digestive function. There isn’t a lot of evidence on this but is a low risk option if you prefer to avoid medications. During my first pregnancy, I used DoTerra roll-ons in peppermint and Digest-Zen religiously and do think it helped. I’d take a long whiff of the scent then roll it on - Peppermint on my wrists, temples, or even under my nose to help combat triggering smells and the Digest-Zen on my wrists and upper belly.

Please note, with essential oils it’s very important to use pure, high-quality products, to dilute them before topical use, and to spot-test it on your skin first as they sometimes can cause skin irritation. I do not recommend taking essential oils orally during pregnancy, unless recommended by your doctor or midwife.

Consider Pausing your Prenatal

If it’s making you really nauseous, you can temporarily stop taking your iron-containing prenatal and replace it with methyl-folate alone or a multivitamin with low iron. Of course, talk to your doctor about this first. If you have known iron deficiency prior to pregnancy, then you may want to consider an IV infusion containing iron to help replete your nutrient status without making you feel worse.


Medications

Doxylamine

This is a first-generation antihistamine, like diphehydramine (Benadryl) and meclizine (Antivert), which decrease the stimulation of the vomiting center. It’s pregnancy category B. Doxylamine is commonly found in combination with B6 in the over-the-counter medication Unisom, but has been shown to be effective alone as well. The most common side effect is drowsiness, hence its use as a sleep aide.

Antacids

Heartburn is a common symptom in the first trimester and may trigger NVP. Calcium-based antacids like Tums are safe and effective. H2-blockers like ranitidine (Zantac) and famotidine (Pepcid) are considered safe (category B) for treating heartburn or acid reflux if other antacids stop working.

If all else fails, prescriptions can help

For severe symptoms that don’t improve with the above measures, talk to your midwife or OB about medications like metoclopramide (aka Reglan). This increases gastric transit and normalizes irregular digestive muscle contractions. It’s pregnancy category B and has shown to be safe but does come with some side effects like drowsiness, dizziness, dystonia, and the risk of tardive dyskinesia with chronic use.


Ondansetron (aka Zofran) is a commonly used medication for nausea but its use during pregnancy is controversial. It’s surprisingly pregnancy category B despite several studies linking its use in first trimester with a higher incidence of fetal heart defects. It has been shown to be effective in reducing vomiting in HG, especially in combination with doxylamine and B6.

Other antiemetics like Promethazine (Phenergan) are pregnancy category C. It’s possible that they may cause birth defects if taken during pregnancy, but studies are mixed. Promethazine is widely used to treat NVP in many countries, despite it’s classification and side effects like dry mouth, drowsiness, and sedation.

As always, talk with your doctor before starting any supplement or medication.

This article is purely for educational purposes and does not substitute for personalized medical advice.

If you’d like to work with me, you can schedule a free consultation here.



Mama, you can and will get through this! Sending you much love!




References

PMID: 27986189

PMID: 27209471

PMID: 10516152

PMID: 17002954

PMID: 24646807

PMID: 24642205

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