Morning sickness, a term for nausea and vomiting during pregnancy, is common in early pregnancy and affects nearly 75% of pregnant women.1 Morning sickness typically starts four to six weeks after conception and often improves or is entirely alleviated r by the 3rd or 4th month of pregnancy.1,2 However, in some cases, it can persist beyond the first trimester or even throughout the entire pregnancy. Morning sickness is often at its worst early in the morning yet can occur at any hour, day or night, or in rare cases, can persist all day. In the vast majority of pregnancies, morning sickness will not harm you or your baby. However, in the most severe cases, morning sickness can lead to dehydration, significant weight loss or an imbalance of electrolytes such as sodium and potassium. The most severe form of morning sickness is a condition called hyperemesis gravidarum, which affects less than 1% of all pregnancies.1
If you experience persistent nausea and vomiting during pregnancy, then consult with a medical professional to rule out other possible causes that may require treatment, such as bladder infections, stomach flu or other health issues.
Initially, your doctor may advise a conservative approach to managing morning sickness, like making changes to your diet and lifestyle or supplementation with vitamin B6 or ginger. If these measures fail to relieve your symptoms, there are some other safe options available, such as prescription medicines, including medications for nausea and vomiting.1 If you experience severe and persistent vomiting (more than 3 times a day), you need to inform your doctor as you may require more intense treatment, such as rehydration therapy.1
In this article, we explore several effective strategies to manage morning sickness, offering key tips and safe remedies. Walking through the benefits of ginger and Vitamin B6 provides valuable insights to help you experience a happier and healthier pregnancy.
What causes morning sickness?
The exact cause of morning sickness is not known, but it is believed to be linked to changes in hormones like estrogen, progesterone or human chorionic gonadotropin ( hCG), a hormone produced by the placenta following conception.2
Other causes might include Blood pressure fluctuations and low blood sugar. or changes in metabolism brought on by pregnancy.2 Morning sickness can often be worsened by:
- Eating or smelling certain foods
- Warm weather or overheating.2
What are the risk factors for morning sickness
Morning sickness can affect any pregnant woman. However, it is more likely to affect those who:
- Are pregnant with multiple fetuses, i.e. twins
- Have a history of morning sickness in a previous pregnancy
- Have a history of motion sickness or migraine headaches
Hyperemesis gravidarum is more probable for those who:
- Have a family history of the condition
- Have experienced this condition in a previous pregnancy
- Are you pregnant with a girl.3
Diet and Lifestyle changes
If your symptoms are mild, your doctor or obstetric care provider will initially recommend making some changes to your diet and lifestyle, such as:
- Eating dry toast or crackers in the morning as they can help calm an upset stomach
- Eat bland foods like bananas, rice, dry toast, gelatin, broth, apple sauce or eggs.
- Avoid spicy, high-fat, and salty foods
- Drink frequent small volumes of fluids, especially water, and avoid caffeinated beverages.
- Include nutritious, protein-rich and low-fat dairy snacks in between your meals, like yoghurt, cheese, nuts, apple slices or celery with peanut butter.
- Avoid skipping meals and try to have small, regular meals instead of infrequent large meals.
- Get plenty of rest.
- Make sure your room is well-ventilated, and go outside occasionally to get some fresh air.
- Don’t lie down immediately after eating.
If taking any prenatal vitamins, ensure they are taken at night as the iron they contain may upset the stomach. Also, take them with a snack or meal, not on an empty stomach.
Try acupressure wristbands. These bands apply pressure to your wrists and there is some evidence suggesting that this pressure can relieve the nausea.2
Try acupuncture. Acupuncture is generally considered safe during pregnancy. During this treatment, fine needles are inserted into specific areas of your body to relieve symptoms.2
Herbal therapies and supplements
Ginger and Vitamin B6 supplements have been shown to offer significant relief in alleviating morning sickness during pregnancy.
Ginger is a plant native to Asia, with a long history of being used for its anti-nausea properties. The Raw ginger root is rich in essential nutrients such as potassium, phosphorus, magnesium, manganese, zinc, iron and niacin.4 While there is evidence supporting Ginger’s potential to alleviate the discomforts of nausea during pregnancy, It’s worth noting that different countries have varying recommendations for its use. For instance, Finland and Russia prohibit its use due to the lack of clear enough conclusions to allow healthcare professionals to confidently recommend ginger as a safe option.4
On the other hand, the American Society of Obstetrics and Gynaecology recognizes ginger as a non-pharmaceutical treatment for nausea and vomiting.5
Ginger is available in various forms, including drinks like ginger ale made with real ginger as well as candies and biscuits. Alternatively, ginger can be added to recipes or incorporated into tea using fresh, grated ginger.
Always consult with your pharmacist or other healthcare provider before taking ginger supplements during pregnancy.
Vitamin B6 (Pyridoxine), is a water-soluble vitamin that has been shown to alleviate symptoms of morning sickness during pregnancy.
The Academy of American Family Physicians recommends Vitamin B6 as the starting treatment option for easing nausea during pregnancy before trying any other medicine.1
Vitamin B6 is found in many foods, including poultry, meat, fish, chickpeas, vegetables and fruits, especially dark leafy greens, bananas, papayas and oranges.
A study of 342 women found that taking a daily 30 mg supplement of Vitamin B6 reduced nausea compared to those who did not take Vitamin B6.5 More research has been carried out to confirm and strengthen these findings.
Vitamin B6 is not only helpful for easing the symptoms of morning sickness but can also have several positive effects on both the mother and the developing baby.
Vitamin B6 is a very important coenzyme (a helper molecule that works together with enzymes) involved in numerous chemical reactions in the body. One of its roles is helping to create chemical messengers called neurotransmitters like dopamine, serotonin and GABA.6 These neurotransmitters are essential for the normal development of the baby‘s brain during pregnancy and after birth. Recent studies also suggest that Vitamin B6 protects against birth defects like orofacial clefts and abnormalities in the heart or blood vessels.6
Pregnant women should always consult with the doctor about vitamin supplementation and dosages.
What medications are available to treat morning sickness?
When the above-mentioned approaches do not work, there are some alternatives to consider.
Vitamin B6, when used alone, may not always be effective in treating the symptoms of morning sickness. In such cases, a combination of Vitamin B6 and doxylamine, an antihistamine, is commonly prescribed as a safe option during pregnancy, with no harmful effects for the developing baby.
Additionally, if other treatments fail to alleviate symptoms of nausea and vomiting, your doctor may recommend anti-sickness medications, also known as anti-emetics, including antihistamines in tablet form, which are considered safe to use during pregnancy. Alternatively, your doctor might suggest an injection or suppositories if swallowing tablets becomes difficult.7
When to seek medical advice
If you experience vomiting and any of the following symptoms, then you should contact a medical professional:
- Abdominal pain
- High temperature
- Vomiting blood
- Unintended weight loss (more than 1 Kg in a week)
- Extreme weakness, dizziness or feeling faint when standing up
- Persistent vomiting (more than 3 times a day)
- Have very dark-coloured urine or you have not urinated in over 8 hours.7
Morning sickness is a common condition affecting 75% of pregnant women. While generally not harmful, morning sickness can sometimes become serious, leading to dehydration and weight loss. Dietary and lifestyle modifications, such as consuming ginger, have been shown to offer significant relief in reducing nausea. Treatment typically includes Vitamin B6 supplementation or prescription medications that are safe to use during pregnancy, including anti-sickness medications. You and your doctor or obstetric care provider can discuss the benefits and risks and help you decide the best treatment for you. Be mindful that severe vomiting is not a normal aspect of pregnancy and requires special medical care. If your doctor suspects hyperemesis gravidarum, you might need medical treatment.
- Herrell HE. Nausea and vomiting of pregnancy. Am Fam Physician. 2014 Jun 15;89(12):965–70.
- Cleveland Clinic [Internet]. [cited 2023 Jul 31]. Morning sickness: when it starts, treatment & prevention. Available from: https://my.clevelandclinic.org/health/diseases/16566-morning-sickness-nausea-and-vomiting-of-pregnancy
- Mayo Clinic [Internet]. [cited 2023 Jul 31]. Morning sickness - Symptoms and causes. Available from: https://www.mayoclinic.org/diseases-conditions/morning-sickness/symptoms-causes/syc-20375254
- Stanisiere J, Mousset PY, Lafay S. How safe is ginger rhizome for decreasing nausea and vomiting in women during early pregnancy? Foods. 2018 Apr 1;7(4):50
- Vutyavanich T, Wongtra-ngan S, Ruangsri R. Pyridoxine for nausea and vomiting of pregnancy: a randomized, double-blind, placebo-controlled trial. Am J Obstet Gynecol. 1995 Sep;173(3 Pt 1):881–4.
- Salam RA, Zuberi NF, Bhutta ZA. Pyridoxine (Vitamin b6) supplementation during pregnancy or labour for maternal and neonatal outcomes. Cochrane Database Syst Rev [Internet]. 2015 Jun 3 [cited 2023 Aug 1];2015(6):CD000179.
- nhs.uk [Internet]. 2020 [cited 2023 Aug 2]. Vomiting and morning sickness. Available from: https://www.nhs.uk/pregnancy/related-conditions/common-symptoms/vomiting-and-morning-sickness/