Private morning sickness & hyperemesis clinic in London, same-day women's health.

What is typical

It is rarely confined to mornings. Nausea often lasts all day, and smells that were previously unremarkable become intolerable. It is more common in first pregnancies and multiple pregnancies, and it often runs in families.

Self-help worth trying

• Eat before you get up — a dry biscuit or a piece of toast by the bed, then a few minutes before moving.
• Small amounts, very often. An empty stomach makes nausea worse; a full one triggers vomiting.
• Cold food often smells less and is better tolerated than hot.
• Sip fluids constantly rather than drinking glassfuls — try ice cubes, ice lollies or diluted squash.
• Ginger has modest evidence and is safe. Acupressure wristbands help some people.
• Rest. Tiredness makes it markedly worse, and pushing through is counterproductive.
• Take iron-containing prenatal vitamins at night, or switch to folic acid alone temporarily if they make you sick.

Medication

• Several anti-sickness medicines are well established and safe in pregnancy, with decades of use and reassuring data.
• They work best taken regularly rather than only when you feel sick.
• If the first does not help within a few days, a different one or a combination often will — come back rather than concluding nothing works.
• Some cause drowsiness; some cause constipation, which is worth treating alongside.
• Thiamine (vitamin B1) supplementation is important with prolonged vomiting, to prevent a rare but serious neurological complication.
• Intravenous fluids may be needed, and can often be given as a day case rather than requiring admission.

The rest of it

Severe pregnancy sickness is isolating, affects work and relationships, and is associated with low mood and anxiety — not because women are weak, but because months of relentless vomiting would affect anyone. Say so if that is where you are. Dental enamel also suffers: rinse with water rather than brushing straight after vomiting, and wait an hour.