Morning Misery: How to Combat Morning Sickness

Pregnant women holding a smartphoneCongratulations! You have just discovered that you are expecting a beautiful bundle of joy. The first few weeks of pregnancy are exciting–albeit, somewhat scary. You have spent the last few months making sure your diet was rich in iodine (…Right? If not–check out this blog post to see the benefits of an Iodine rich diet in preconception and pregnancy!), you’ve kept your body in an optimal reproductive state, and you are beginning your family. Or, you had no plans to become pregnant–but oh what a blessing it is! You have been so excited…until this morning, you woke up with morning sickness.  You knew this would happen, but you had no idea it would be this bad. Instead of spending your mornings excitedly skipping to work (because that’s what we all do, right?), you spend your morning wrapped around the porcelain throne wondering how on earth you still have anything left in you. Sound familiar? Thought so. Not to fear! We are going to chat today about the nutrition implications affecting morning sickness and what options may be better than others to keep nausea at bay. 

How to Combat Morning Sickness

So…what gives? What is it that causes morning sickness? According to a Journal published in 2018, titled The Effect of Young Coconut Water against Morning Sickness among Women in the First Trimester of Pregnancy, by Ariestini and Purnomo, morning sickness is caused by the influence of pregnancy hormones on the gut. The article states:  “The slowing motility of the gastric muscles due to the influence of pregnancy hormones causes an increase in the amount of stomach acid that irritates the gastric mucosa. Pregnant women experience nausea, vomiting, bloating, frequent burping, sour taste, bitterness, loss of appetite, and discomfort which causes the loss of fluids and some essential minerals, such as sodium, potassium, calcium, and magnesium.” You can see why long term morning sickness could lead to some pretty serious complications, including Hyperemesis Gravidarum, or severe morning sickness lasting past the 14th week of pregnancy. HG can lead to dehydration, electrolyte imbalances, and even severe weight loss. That being said, we want to get morning sickness under control if at all possible! 
During the first trimester, you don’t need much more in terms of calories compared to what you needed before you became pregnant.
That being said, you need to be able to keep the food you’re ingesting down. If you can’t due to morning sickness, you won’t be getting enough calories for you yourself, let alone you and baby. Elisa Zied, M.S., R.D., suggests that it is more important to focus on foods you can actually stomach rather than nutrition itself (Gullon, 2011). Making sure you take a quality prenatal vitamin is essential, ensuring you’re getting in your daily dose of folate and other important vitamins and minerals. Ryann covers what to look for in a prenatal vitamin in this post. Plus has a list of her most commonly recommended prenatal vitamins and nausea management tools in The Prenatal Nutritionist Amazon shop. Once nausea subsides, focus on eating a more balanced, nutrient-dense diet.  

So, what are some foods that may be better tolerated while experiencing nausea?

The Nutrition Care Manual suggests keeping foods relatively bland, and keeping snacks like Saltine crackers and pretzels on deck at all times. They also recommend the following tips: – Try to eat 6 small meals/snacks during the day. Small meals may be easier to tolerate than large meals. – Keep easy to digest foods, such as crackers and pretzels, with you during the day and at your bedside. You may even try eating a few crackers before getting out of bed in the morning. – Drink water or other beverages (caffeine-free) between meals. – Eating ginger may improve nausea. – Lower-fat foods are easier to digest. High-fat foods can make nausea worse. (Nutrition Care Manual, 2019)
Try eating foods that may not be your absolute favorite.
You’ve heard the horror stories: Martha can’t eat her favorite cereal anymore because last time she ate it…it all came back up…and she can’t look at it the same again. Opt for foods that are flavorless and cool, like dry toast or maybe popsicles and frozen fruit. The Nutrition Care Manual also recommends easy to digest foods like mashed potatoes, soups, or puddings. If it is easier to keep down liquids, trying calorie-dense drinks like smoothies with peanut butter, juices, or broths are a great option to keep your energy up (Nutrition Care Manual, 2019). 
During your bouts of morning sickness, limit foods that could intensify your morning sickness.
Foods that could potentially be raw or undercooked, such as undercooked meats are smart to avoid. Additionally, if you have a lactose intolerance or sensitivity, consuming dairy foods may make your symptoms even worse. Try to limit heartburn causing caffeine, unpasteurized cider and juices, and of course, no alcohol. These foods may cause GI distress or acid reflux, which will only enhance your symptoms.  If you feel that your morning sickness is only getting worse as time goes on, please discuss this with your doctor or registered dietitian. Your medical team can work together to create a plan best suited for you and help you get your morning sickness under control so you can fully enjoy this special time. 

Looking for more immediate nutrition help? Click here to download a 5-DAY meal plan!

Written by: Kaleigh Eastep, Dietetic Intern Edited by: Ryann Kipping, RDN, CLEC References:  Ariestini, T. R., & Purnomo, W. (2018). The Effect of Young Coconut Water against Morning Sickness among Women in the First Trimester of Pregnancy. Indian Journal of Public Health Research & Development, 9(11), 1729. Retrieved from GULLON, M. (2011). Food Fixes. Fit Pregnancy, 18(1), 70–99. Retrieved from Owe, K. M., Støer, N., Wold, B. H., Magnus, M. C., Nystad, W., & Vikanes, Å. V. (2019). Leisure-time physical activity before pregnancy and risk of hyperemesis gravidarum: a population-based cohort study. Preventive Medicine, 125, 49–54. Nutrition Care Manual. Morning Sickness Nutrition Therapy. (2019).