By Dr. Jessica Liu, ND

I can still recall the all-day nausea and violent vomiting I experienced well into my 3^rd trimester of pregnancy with my son Jonah.  I remember a daily routine of waking up and eating a first breakfast, knowing it would end up coming back up and then trying to squeeze in a second breakfast before work.  Needless to say, I can certainly empathize with many of my pregnant patients who struggle with nausea and vomiting on a daily basis, sometimes lasting well beyond the first 12 weeks of pregnancy.
 
Naturopathic medicine offers many great tools to curb nausea and vomiting that are safe in pregnancy.  But more importantly, what has become very apparent to me in working with couples trying to conceive is also how critical pre-conception nutrition is to the prevention of nausea and vomiting in pregnancy.  
 
Here are a few things that I have learned in dealing with my own nausea during pregnancy:
 

1. Starting a pre-conception diet that includes an adequate balance of healthy proteins and fats, minimal processed carbs and sugars, mineral and antioxidant-rich vegetables and fruits.  Studies have shown that a low-inflammatory diet can have a protective effect against nausea and vomiting in pregnancy. The catch? Ideally, you would want to make these dietary changes in the 4-6 months prior to conception!

2. Having an adequate level of magnesium in the body. Severe nausea and vomiting of pregnancy can be related to a magnesium deficiency. Magnesium is an important mineral in multiple systems of the body and thus is vital to have in adequate amounts during pregnancy. Green leafy veggies such as spinach and swiss chard, as well as nuts and seeds can provide a great source of magnesium.  During pregnancy, topical magnesium oil or safe dosing of oral magnesium bisglycinate can dramatically reduce nausea.

3. Nausea in pregnancy may be related to a deficiency of Vitamin B6. B6 is a critical nutrient in many biochemical pathways, including the production of our ‘happiness’ neurotransmitter, serotonin, as well as some of our sex hormones. B6 is vastly depleted with the use of oral contraceptives, which Is such a common practice today among women right before conception. New research as shown that the first-line conventional medication, Diclectin, has no benefit in preventing nausea of pregnancy over Vitamin B6 alone. 

4.  Nausea in pregnancy may be a mother’s way of regulating iodine levels in the body.  During pregnancy, a woman’s need for iodine doubles.  Iodine is a crucial nutrient in healthy thyroid function and in the healthy neurological development of the fetus.  Some studies suggest that vomiting in pregnancy is a way of ensuring a mother does not take in excessive amounts of iodine, thereby regulating her thyroid hormone levels.

5. You can’t go wrong with good old Ginger!  To be honest, there were times in my pregnancy where the mere thought of eating ginger or drinking ginger tea would make me nauseous, but the days where I would be able to stomach it, it did seem to make a big difference. If you are turned off by the taste of ginger, try ginger capsules!

 
Other therapies worth mentioning:
 

1. Homeopathy – these are very diluted gentle remedies that are safe in pregnancy and can be very effective.  They work best when a skilled practitioner selects a specific remedy that best fits the total symptom picture of the patient.

2. Acupuncture – In Traditional Chinese Medicine, nausea in pregnancy is explained as an abnormal surge of digestive ‘Qi’ or energy in an upward direction. Acupuncture and acupressure can be extremely effective at calming down nausea.

3. Hypnotherapy – A gentle relaxation technique that can help to calm the nervous system and reduce frequency of nausea and vomiting episodes.

 
Nausea is Protective!
 
There is a silver lining when it comes to nausea/vomiting in pregnancy and it’s that it correlates with healthy pregnancy hormone levels, and thus a stronger pregnancy with a lower risk of miscarriage.  It has also been shown that babies born to mothers who experienced severe nausea and vomiting in pregnancy tended to have higher IQs later in life!
 
The best piece of advice?
 
Make sure to have small frequent meals (nausea of pregnancy is also associated with low blood sugar), stay well hydrated (think coconut or lemon water for electrolytes) and as much as you can, REST!  Take heart in the fact that all that extra hard work your body is doing is working towards creating your perfect and heal little baby!
 
References: 

1. Hovdenak N1, Haram K. Influence of mineral and vitamin supplements on pregnancy outcome. Eur J Obstet Gynecol Reprod Biol. 2012 Oct;164(2):127-32. doi: 10.1016/j.ejogrb.2012.06.020. Epub 2012 Jul 6.
2. Forbes, S. Embryo quality: the missing link between pregnancy sickness and pregnancy outcome.  Evolution and Human Behaviour, March 2017 Vol 38, Issue 2, p 265-278. 
3. Persaud, N, Chin, J, Walker, M. Should doxylamine-pyridoxine be used for nausea and vomiting of pregnancy? J Obstet Gynaecol Can 2014;36(4):343-88.
4. Shrim A. et al. Pregnancy outcome following use of large doses of vitamin B6 in the first trimester.J Obstet Gynaecol. 2006 Nov;26(8):749-51.
5. Fischer-Rasmussen W, Kjaer S, Dahl C, et al. Ginger treatment of hyperemesis gravidarum. Eur J Obstet Gynecol Reprod Biol. 1991;38:19–24.
6. Smith C, Crowther C, Beilby J. Acupuncture to treat nausea and vomiting in early pregnancy: a randomized controlled trial. Birth. 2000;29:1–9
7. Brandes JM. First trimester nausea and vomiting as related to outcome of pregnancy. Obstet Gynecol. 1967;30:427–431.
8. Nulman I et al. Long-term neurodevelopment of children exposed to maternal nausea and vomiting of pregnancy and diclectin. J Pediatr. 2009 Jul;155(1):45-50, 50.e1-2. doi: 10.1016/j.jpeds.2009.02.005. Epub 2009 Apr 24.