Guidelines offer women options for treating ‘morning sickness’ during pregnancy

Stomach-churning symptoms range from mild to severe, she said. “It’s the spectrum — a little bit (of sickness) or you could be throwing up many times a day.”

Sometimes, women can’t ingest either liquids or food and are in danger of being dehydrated and not getting adequate nutrition; some end up being admitted to hospital, as was the case with Catherine, the Duchess of Cambridge.

“In the more extreme cases, where you can’t keep anything down, you can’t socialize properly, you can’t go to work, you can’t look after your children, you can’t care for your family and yourself,” Campbell from Vancouver.

“So it can be significantly debilitating.”

The SOGC document advises women suffering from pregnancy-related digestive upset to start with non-drug treatments such as ginger, vitamin B6 and acupressure to ease their symptoms.

“There are some new medications on the market, but there isn’t necessarily a magic bullet,” she said. “What we have now is more information about some natural approaches that are accessible to everybody, like the ginger and the acupuncture and acupressure.

“These are things women should feel completely free to do and they’re easily accessible and they’re very affordable for them.”

Vitamin B6 is another option for quelling a rebellious stomach, with a recommended dose of 10 milligrams, four times a day.

There is also new evidence that women experiencing nausea and vomiting during pregnancy may safely stop taking iron-containing prenatal vitamins during the first trimester — when extra iron is not yet needed — and substitute folic acid or a vitamin supplement low in the mineral.

Foods that a woman eats may not be as important as once thought. In the past, women with morning sickness were advised to eat small, bland meals and avoid fatty foods like potato chips. But research shows changing the diet may have limited effectiveness, and doctors say women should eat whatever pregnancy-safe foods appeal to them.

Foods considered possibly unsafe during pregnancy include those with a potential to cause infection.

“So we teach women to avoid foods that have a higher risk of carrying Listeria,” said Campbell, noting vegetables should be washed well, while deli meats, uncooked meats, unpasturized dairy products and soft cheeses should be given a pass.

Pregnant women often have a strong aversion to odours — including certain foods — so they “may want to limit what they’re exposed to because there’s triggers that set them off,” she said.

For Campbell, it was the smell of meat cooking.

“I definitely was motivated to write this,” she said of the SOGC guideline document, “because I was definitely affected with my second pregnancy.

“And morning sickness is the wrong name — it affected me all day. I would walk around feeling as if I was about to throw up at any minute.”

The guidelines are, of course, also aimed at physicians, who can work their way down the list of potentially effective treatments, including medications that contain antihistamines, if one therapy or another doesn’t work.

Medical marijuana has been touted as an anti-nausea therapy for some people — for instance, for cancer patients undergoing chemotherapy. But smoking any substance is considered a major no-no during pregnancy.

Campbell said the SOGC committee that wrote the guidelines did discuss marijuana, but decided not to include it.

“We couldn’t find anything in (research) evidence about treatment for this in pregnancy and we suggested there are so many other harms with this particular intervention … that we did not even mention it,” she said.

“We just didn’t feel that we could comment on it at this time.”

Online:

A copy of the guideline is available by at http://www.jogc.com/article/S1701-2163(16)39464-6/fulltext

– Follow @SherylUbelacker on Twitter.

Sheryl Ubelacker, The Canadian Press

by Canadian Press

Guidelines offer women options for treating ‘morning sickness’ during pregnancy

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