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posted: 5/5/2014 5:45 AM

Stay well-hydrated to reduce severity of morning sickness

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Q: I'm in my first trimester of pregnancy and battling terrible morning sickness. What can I do to feel better?

A: Morning sickness can put a damper on an otherwise joyous time. It is very common, affecting 50 to 90 percent of pregnant women. In most cases, the nausea and vomiting associated with morning sickness start around the fifth or sixth week of pregnancy. They are worst around the ninth week and start to go away around the 16th week.

The severity of morning sickness varies widely. Some women experience only mild nausea, while others have severe nausea and vomiting that lasts all day.

When you have morning sickness, the most important thing is to stay hydrated. This can be difficult if you are not eating and drinking enough, or are vomiting several times a day. Aim to drink 8 to 10 cups of fluid per day. Here are some tips to prevent dehydration:

• Drink ginger, peppermint or decaf tea.

• Drink water with lemon juice.

• Try drinking beverages with electrolytes, such as Gatorade, Pedialyte, coconut water or broths.

• Eat foods with high water content, such as watermelon, grapes, oranges, cucumbers, fruit ices or Popsicles.

• Avoid caffeine.

Dietary changes can help to keep nausea at bay:

• Eat four to six small meals throughout the day.

• Eat foods high in protein such as low-mercury fish, chicken, nuts, peanut butter, eggs, yogurt and cheese.

• Avoid spicy or fatty foods, or foods that have a strong aroma.

• Keep dry crackers or toast next to your bed.

• Try eating plain, bland foods such as crackers, cereal, toast, pretzels, mashed potatoes and applesauce.

• Suck on hard ginger candies or drink ginger tea.

• Try sniffing a lemon or adding lemon juice to your food or water.

• Take your prenatal vitamin before bed with a snack.

Finally, steer clear of environmental triggers such as noise, touch, odors or motion, which may also trigger nausea. (I've listed environmental triggers and tips to avoid them on my website,

If your morning sickness continues to be severe and unrelenting, talk to your doctor about medications that may help. Several medications can ease the symptoms and do not cause adverse effects for the developing baby.

These include pyridoxine, doxylamine, diphenhydramine, meclizine, dimenhydrinate, ondansetron, prochlorperazine and metoclopramide.

Although I have not treated many women for morning sickness myself, my colleagues in obstetrics tell me that today's treatments are superior to those available when they began training.

That's good news for the many women who experience this temporary but often debilitating illness.

Dr. Komaroff is a physician and professor at Harvard Medical School. To send questions, go to

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