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The first trimester is literally the worst!



7 survival strategies for morning sickness

So, you're pregnant. Before the stick turned blue, you imagined you'd spend these early months fielding congratulatory hugs, mooning over tiny outfits, and savoring carefully balanced, nutrient-filled, folate-rich meals. But someone forgot to tell your body.

Your soft-focus dreams have come up against a far less pleasant reality: gagging in the bathroom at 2 am, praying you'll make it through your business meeting without having to bolt, desperately rummaging through the pantry for something - anything - you can keep down for more than five minutes.

"Though some people tend to make light of morning sickness, it is no joke," says Miriam Erick, M.S., R.D., a registered dietitian at The Brigham and Women's Hospital in Boston, who is known to her patients as the "morning sickness maven." "It is truly debilitating. A severe case can disrupt a woman's career and family life and even threaten her long-term health. For such women, the old 'crackers and jell-o' mantra isn't going to cut it."

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The bad news is that there's no one-size-fits-all cure. The good news is that you can learn from Erick's wealth of experience in discovering what does work for the moderately nauseated as well as the sickest of the sick. Her book, "Managing Morning Sickness: A Survival Guide for Pregnant Women" provides proven remedies, nutritional guidelines, and safe, nutritious recipes.

Here are some tips on understanding, coping with, and defeating morning sickness:

1. Try lemons. "Eating lemons has been noted as a remedy for seasickness," says Erick. "In my clinical experience, I've observed a strange but real therapeutic effect of lemons. You can sniff them, suck on them, or sprinkle them with salt and lick them. Lemon is a fragrance that works about 99 percent of the time! Not only is it effective in relieving nausea, it has been proven to relieve depression."

2. Track your triggers. If you chart your episodes of nausea or vomiting, you are likely to discover patterns that reveal contributing factors. Do certain smells make you nauseated? Taking medication, eating or drinking at certain times of the day? Being exposed to heat or humidity? Hearing loud noises? Being "jiggled" by a husband who tosses and turns in bed? As you can see, there are many potential triggers for morning sickness. Only by identifying them can you take defensive action.

3. Realize that bland isn't always best. It's almost a cliché to suggest tea, toast, crackers, and jell-o. It's true that for many women, bland foods are the answer. But others find success with such unlikely choices as cinnamon candies, tater tots, sour cream & onion potato chips, and raw carrots and celery sticks dipped in vinegar. Quite simply, try whatever you think might work, no matter how odd it might seem.

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4. Consider different food categories. Women seem to crave certain tastes/textures when they're feeling sick. Maybe the thought of sweet food makes you feel "green" but the thought of something tart is bearable. Pay attention to these preferences and give your queasy stomach what it wants. "Managing Morning Sickness" provides an extensive list of foods to try, broken down by taste and texture. For instance:
  • Salty: Mashed potatoes with salt and Parmesan, tomato juice, hotdog
  • Bitter/tart/sour: lemonade, lime juice sprinkled on apples, salsa
  • Earthy/yeasty: pumpernickel bread, hummus, asparagus
  • Crunchy: raw zucchini, crisp bacon, taco shells
  • Spicy: gingersnaps, chili peppers, seafood cocktail sauce
The above list is just a tiny sampling. The book also provides a wealth of menus and recipes categorized by these physical/sensory food attributes.

5. Don't feel guilty. Many women believe that if they consume anything on the "do not eat" list, the baby will immediately suffer. Although it is true that a pregnancy will benefit by better eating habits, in morning sickness, it is a very different game. What's the benefit of eating well, vomiting, and having to take anti-vomiting medication rather than eating a few junk foods, foregoing medication, and not vomiting? It's a game of trade-offs.

6. Consider "alternative" remedies. One study from Italy seemed to suggest that the Sea Band, an anti-seasickness wristband with a bead sewn in that supposedly exerts pressure on a nerve connected to the vomiting center in the brain, was helpful in alleviating sickness. "Managing Morning Sickness" reports on other remedies such as hypnosis, acupuncture, and foot reflexology. Common Western herbs such as cilantro, ginger, and peppermint and Eastern remedies like xiao hui xiang (small fennel), Jie Zi (brown mustard seeds), and pu gong ying (known in the U.S. as dandelion) have been found effective-but consult your doctor before taking any substance.

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7. Be glad you weren't born 60 years ago. "As bizarre as it sounds, in the early 1940s a woman who suffered from bad nausea and vomiting may have been given injections of her husband's blood, with the theory that there was something inherent in the spouse's blood that could reduce the problem," writes Erick. "This was not medical management from voodoo men but rather a practice from the United States, if you can believe that!"

Though it may seem small comfort, women who suffer from severe and unrelenting morning sickness deserve what Erick calls The Purple Heart of Motherhood.

"No one's going to pin a medal on you, so you need to honor yourself," she advises. "Nurture yourself as best you can. Take a break from housework. Eat what you can keep down and let everyone else fend for themselves. Insist that restless sleepers bed down elsewhere until the baby is born. And always keep in mind that no matter how terrible you feel, it has to be over in at least nine months. That may not be much to cling to, but Purple Heart Mothers will take whatever they can get."


Miriam Erick, M.S., R.D., is a registered dietitian and nationally known perinatal morning sickness nutrition specialist. Her work in the field spans over 15 years at a major Boston medical institution. An author of three books on the topic and a well-traveled public speaker, Miriam also works directly with sick, hospitalized women with severe morning sickness.