12/04/2012 at 12:21 PM
Why Kate Middleton’s Morning Sickness Is a Royal Pain
by Lauren Streicher, MD
There are a lot of women who can sympathize with Kate Middleton. Nothing spoils the elation of a positive pregnancy test quite like the misery of morning sickness. Fifty percent of women have at least occasional nausea and vomiting during pregnancy, and some are debilitated to the point that they can’t function or work.
Charlotte Brontë, the author of Jane Eyre, actually died from severe nausea and vomiting in the fourth month of her only pregnancy. Rest assured that this was in 1855, prior to availability of IV fluids.
Today, 1% of women are hit with this most severe form of morning sickness, known as hyperemesis, an illness that often requires hospitalization.
Obstetricians generally reassure their patients that the nausea will dissipate by the end of the third month, but some babies don’t get that memo and continue giving trouble for a much longer time. The only good news is that the typical nausea and vomiting of pregnancy is associated with a low rate of miscarriage and rarely affects the growth or development of the baby.
If this brings you little comfort as you run to the bathroom for the third time in an hour, know that there are a number of solutions that will at least allow you to remain functional despite that yucky sick feeling.
My advice to Kate (who doubtless has her own doctor!)? The first step is to forget everything the books say about nutrition during pregnancy and focus on eating things that don’t provoke a gag reflex. Eating small amounts of bland, dry, high-protein foods is her best bet. Lemons also seem to help, and while it has not been confirmed that ginger in food decreases nausea, one study established that ginger tablets seem to make a significant difference. She should keep something in her stomach all the time, and try eating multiple small snacks throughout the day, rather than three big meals. The goal is to maintain weight and not get dehydrated. Even if she loses a few pounds and eats nothing more nutritious than popcorn and lemonade, there will be no impact on the little prince or princess’ health.
Vitamin B6 (10-25 mg every 8 hours) and the antihistamine doxylamine have been shown in many studies to reduce nausea by as much as 70%. In addition, many anti-nausea drugs are safe in pregnancy for the 10% of women who have severe symptoms. If she is unable to keep anything down, she should call her doctor sooner rather than later.
Acupressure and acupuncture are worth trying since some studies show a benefit. Wearing anti-nausea wristbands (unless you are on a boat) is the equivalent of putting a billboard on her forehead announcing that she is pregnant. Since the tabloids have already announced it to the world, it shouldn’t be an issue.
Prior to my first pregnancy, I didn’t worry too much about handling the nausea that my patients complained of. In fact, I actually thought I would welcome it, hoping I wouldn’t be tempted to eat too much. But then it hit. Years later, certain triggers still bring back that horrible feeling that is impossible to fully appreciate unless you have experienced it yourself and helps me understand why my patients are so desperate for a solution.
Kate, I sympathize.