I am almost 14 weeks pregnant, due in early May 2014!  I’ve been struggling with nausea since the 5th week, but it’s finally, gradually beginning to abate.  Now that I’ve gotten through this phase of pregnancy two-and-a-half times (my second pregnancy died at 7 weeks; the only good thing about that was ending the queasiness!) I feel qualified to share some advice on how to cope with the horrible experience of feeling sick to your stomach for at least part of every day for two months straight.

Every mother is different.  Every pregnancy is different, even for the same mother; some details of my experience were different each time.  But I hope that my tips will give you at least a few helpful ideas.

The most important thing to know is that almost everything you know about how to react to queasy feelings and vomiting is wrong.  Probably most of your experiences with stomach upheaval have been caused by illnesses or food poisoning.  In those circumstances, you want to get the bad stuff out of your stomach and then leave it empty so it can rest; when you start eating again, you need to choose very simple, quickly digested foods; you shouldn’t eat more of the food that made you sick.  This is all very wise when your queasiness is caused by germs.  But when it’s caused by pregnancy, these behaviors will make it worse or just won’t help.  In fact, when you’re pregnant, a queasy feeling usually means you’re hungry.  It took me weeks to learn this in my first pregnancy, and I didn’t feel hunger that felt like hunger until about the sixth month.

Eat like a hobbit.  Start by putting some kind of nourishment–even if it’s only a few bites–into your mouth every hour while awake.  Within a couple of weeks, you’ll learn at which times of day you can eat larger amounts less frequently.  Develop a routine of frequent meals and snacks, adjusting as you find out what works best for you.  This is my basic routine:

• First Breakfast.  Eat something before you even get out of bed.  A lot of pregnancy books recommend saltine crackers or pretzels for this purpose.  However, these starchy foods are difficult to eat if your mouth is dry, and in my second and third pregnancies I got a horrible aftertaste from all bread-type foods.  (My mother told me this is an amylase reaction.  I’m apparently just more grossed-out by the sweet taste of it when pregnant.)  Almonds are really good for easy eating in the dark, triggering just enough saliva to help you swallow them, and providing some protein which may settle your stomach better than simple carbs.  I bought organic, steam-pasteurized almonds in bulk at the food co-op.
• Second Breakfast.  As soon as you get up, eat a smallish portion of an easily digestible food.  My favorites are organic cornflakes with milk, or warmed-up leftover rice with butter and either seaweed sprinkles or nutritional yeast flakes.  (B vitamins, found in both nutritional yeast and seaweed, may help with nausea.)
• Elevensies.  After you’ve been up and about for a while, eating feels more feasible.  Do not make yourself wait until lunchtime.  Don’t even wait until 11:00 if you feel hungry/queasy earlier!  Try to get in some significant protein and/or fat at this point.  Some days I’ve ended up walking Nicholas to school and then going back home for my “elevensies” at about 8:30 before I go to work.  Some things I like to eat at this point are yogurt, scrambled eggs with toast, or a peanut butter and jelly sandwich.
• Lunch.  By this point in the day, I’m usually able to eat much the same kind of thing I would when not pregnant, but I have to be careful not to eat too much at once.  If going out to lunch, bring a container to save leftovers.
• Tea-time.  Eat at some point during the afternoon.  It’s especially crucial if you work outside the home and go home at dinnertime–and even more crucial if you don’t have a Daniel making dinner ready around the time you get home, like I do–that you don’t ignore late-afternoon hunger thinking you’ll soon be eating dinner.  It’s not “soon” enough when you have an embryo draining away your nutrients!  Especially if there is any delay in getting home, you can get dangerously hungry, and that often leads to throwing up the first thing you eat.  Practice pre-emptive snacking!
• Dinner.  Like lunch, this should be a normal meal, but don’t over-eat.
• Nighttime Snack.  I’m often surprised at how quickly my dinner seems to disappear.  Two to three hours later, I can eat another full meal!  This should be something nourishing, not dessert.  If you do feel like eating sweets, also eat some protein that will digest more slowly.  This prevents you from running out of calories so completely during the night.

If you wake up in the night, eat!  During all of my pregnancies, I have awakened somewhere between 3:30 and 6:00 almost every morning in the first trimester.  This is when I have First Breakfast.  Some days, I can’t get back to sleep right away, so I get up and have Second Breakfast, brush my teeth, and then go back to bed.  This may or may not enable me to go straight to Elevensies when I get up for the day at 6:45–if I’m still feeling iffy, I have another round of Second Breakfast.

Be careful about drinking too much water, especially first thing in the morning.  When not pregnant, the first thing I do upon awakening is pour down at least a pint of cold tap water.  But when I’m pregnant, the valve at the top of my stomach is in a touchy mood, and it reacts to that sort of thing by going, “Glug.  Glug.  AAARRGGHHH I CAN’T TAKE IT ANYMORE!!!” and suddenly flinging my stomach inside-out.  So I need to limit water to 1/2 cup until I’ve eaten a significant amount of food.  A dry mouth can be relieved by holding and swishing a small mouthful of water before swallowing or spitting it out.  Yes, you need to be properly hydrated, but get your fluids in a way that keeps them in you, or it’s useless.  You may find a certain temperature of water more palatable.  If plain water tastes icky, try adding a few drops of lime or lemon juice (I keep a bottle in the refrigerator door) or making it into peppermint tea–peppermint may help with nausea.

Get back on the horse that threw you.  As counter-intuitive as it seems, the best thing you can do after vomiting is eat.  If you got too hungry before eating, you may throw up soon after you start eating.  I know it feels like eating must have been the wrong thing to do, like that particular food made you sick, but that’s not how it is.  It’s not the food’s fault; it’s your stomach’s.  If you avoid every food that’s ever come up, pretty soon you’ll be running out of things to eat!  So the best thing to do is rinse your mouth, take a few deep breaths, drag yourself back to that table, and sit right down and eat some more of that very same food.  I know it’s hard.  But it works!

When in doubt, eat protein.  At times when you feel like you could eat almost anything, choose a food with protein, like beans, nuts, eggs, or yogurt.  You need extra protein to grow your baby’s body while maintaining your own skin, bones, and hair.  Protein also may help to reduce nausea and weak, shaky feelings.

Brush your teeth but not your tongue.  Brushing your teeth after eating prevents problems with aftertastes that might nauseate you after a few minutes.  If your toothpaste tastes weird to you now, try a different, simpler or more natural, toothpaste.  I’m liking original recipe Colgate, which is one of the safest toothpastes and also affordably priced.  When not pregnant, I brush my tongue at least once a day to control lingering flavors and bad breath, but when I’m queasy that will make me gag!  If you have this problem, skip brushing your tongue until you start to feel better.  Brush your teeth after eating, not after vomiting–just rinse after vomiting, because brushing stomach acid into your teeth can cause cavities.

Can you get someone else to cook?  You may find it very difficult to see, smell, or think about food when you are not able to eat it immediately, and that makes meal preparation difficult.  I am lucky to have fallen in love with a man who knows how to cook!  Our usual routine is that I plan our weeknight dinners, and Daniel cooks them.  During the queasy phase, though, I can’t do much meal planning–it just freaks me out.  My maximum input is grabbing his shoulder and rapidly saying something like, “We have a lot of broccoli and if you were to thaw some of the frozen grated cheese we could have mac and cheese with broccoli and that would be good but I have to stop thinking about it RIGHT NOW okay?”  Also, instead of making our weekend meals from scratch, I’ve been cooking things like frozen ravioli and sauce from a jar, on the days when I don’t wimp out of cooking entirely.  Now is the time to cut ourselves some slack by eating in restaurants more often and using more convenience foods.  I’m very lucky to have the budget for that!  For mothers on a tight budget who have no other cooks in the household, another option is to ask friends and neighbors to bring you a meal every so often.  You can repay the favor when you’re feeling better and they are going through a difficult time.

Don’t cook on an empty stomach.  When you must prepare food that won’t be ready within five minutes, first set out a dish of nuts, fruit, or other food to nibble while you work.

Don’t oversleep.  It’s better to get up, eat something, and go back to bed while you digest it, than to sleep late and wake up hungry.  Making yourself get out of the house may help, too, even if you end up going home to rest after a short time.  In my first pregnancy, as soon as I told my boss how sick I was feeling, she allowed me total flextime, so I lounged around at home until I felt ready to go to work (often as late as 2pm), then worked into the evening.  When I was pregnant the second time, though, I had a first-grader to get to school!  I found that making myself eat something and then walk 5 blocks to the school (where I would sit and rest a while) always got me feeling a little better than I’d felt before I left the house.  It’s working this time, too.  Now I wonder if my long mornings of nibbling and napping while expecting Nicholas were really necessary, or if getting some fresh air and exercise would have helped me to eat more earlier and thus start my workday earlier.

Honor your cravings, within reason.  If you want a particular food that is healthy and nutritious, do your best to get it as soon as possible.  If you crave something that’s not the healthiest, but it is generally recognized as food and you aren’t allergic to it, go for it anyway!  Especially if you feel like it’s the only thing you want to eat, it’s better than eating nothing.  Both Nicholas and my second embryo drove me to Nacho Cheese Doritos every so often.  This one wants a Reese’s Peanut Butter Cup every few days and extra sugar on many foods.  Moderation in all things!  I figure there is probably some reason for the craving, something my body genuinely needs–even if it’s in a food that also contains some less-than-ideal ingredients.  For example, in every pregnancy I have adored ramen noodles with an egg scrambled in the hot broth; this is helping my low blood pressure, getting me to drink plenty of water (and keep it down), and giving me a nutritious organic egg (great for baby’s brain development!)–along with the hydrolyzed corn and monosodium glutamate and other crappy ingredients in the ramen.

Avoid the foods with evil vapors.  There may be some foods you normally like that suddenly seem frighteningly repulsive.  Don’t make yourself eat them, even if they are nutritious, even if you stocked up when they were on sale just before their evil became apparent.  Get the rest of the family to eat them while you’re out, or donate them to the needy, or give them to your neighbors.  As with cravings, your body may be trying to tell you something.

Do you have a rescue food?  This is a food that, at the first bite, makes you feel a lot better.  It might be something you can eat by itself, or you might take a bite or two of rescue food to calm you enough that you can decide what else to eat.  My cousin Tiffany, who had severe nausea in every pregnancy, carried little wedges of lime at all times for this purpose.  I’m sad that I’ve never discovered a rescue food for my own pregnancy nausea–but when I tried birth control pills for a few miserable months, I was very queasy, and salsa helped a lot!  Rescue foods that I’ve heard worked for other women are candied ginger, pickled ginger, freshly cut apples, fig bars, and dill pickles.

Control unpleasant odors.  Get every member of your household to help you keep things clean, take out the compost nightly, store strong-smelling foods like onions in tightly sealed containers, ventilate the bathroom, and whatever else is necessary to prevent objectionable odors from zapping your vulnerable senses.  Be vigilant about protecting yourself from truly dangerous vapors, like cigarette smoke and vehicle exhaust.  You may be unusually sensitive to a particular aroma that normally wouldn’t bother you.  In my second pregnancy, the smell of brewing coffee hit me like a poison gas trying to kill me–so Daniel waited until I’d left the house in the morning to make coffee, and stored some leftover coffee in the refrigerator that he could microwave when I was at home.

Use a nice-smelling lip balm.  Putting a peppermint, ginger, or citrus scent right under your nose might help you fight off queasy feelings.  For me, it helped to reduce my reaction to the bitter taste that (until last week) always came into my mouth about two minutes after I finished eating.  Use a natural lip balm like Bee Folks, Dr. Bronner’s, Badger Balm, or Merry Hempsters.

Avoid bending forward sharply.  Bending over from the waist, or lying on your back and sitting up, can pinch open the valve at the top of your stomach.  Instead, bend at the knees when you need to pick up something from the floor.  When you’ve been lying down, roll onto your side, bend your knees, and then roll up onto your knees.  These are good moves later in pregnancy, too, when your abdominal muscles are weakened by spreading out around the baby, and your tummy gets in the way of bending over!

Keep yourself at a comfortable temperature.  Being too cold or too hot can worsen nausea.  Dress in layers that you can easily adjust.  Avoid standing around in the cold or exercising in the heat.  Speak up if a thermostat setting is uncomfortable for you.  If circumstances get you into an uncomfortable temperature for an extended time, recover gradually–don’t shock yourself by jumping right into a hot bath or cold swimming pool.

Vitamin B6 may help.  Talk with your midwife or doctor about the appropriate dosage to take in a supplement, relative to the rest of your diet.  Vegetarians, especially vegans, are most likely to need supplemental B vitamins.  For me, B6 is helpful for preventing headaches as well as nausea.  UPDATE: Later in pregnancy, bloodwork showed that I had a low level of Vitamin B12, which was the reason I was not absorbing iron properly.  Taking a B12 supplement corrected my anemia and stopped my dizzy spells.  It may be the reason that I had no nausea at all for the rest of the pregnancy (except when I had bronchitis and sometimes coughed until I vomited), whereas in my first pregnancy I had a dizzy spell ending in vomiting at least every 2 weeks in months 2-8.

Marijuana may help.  This is, of course, controversial and illegal in many places.  Check out this thorough summary of research on the effects of prenatal exposure to marijuana and this story of a woman who used marijuana to survive Hyperemesis Gravidarum and deliver a healthy baby.  On the other hand, you might find that marijuana just makes you feel dizzy and confused and doesn’t really quell the queasiness.  It’s not for everyone.

Do you have Hyperemesis Gravidarum?  Read Violet’s article for clear advice on how to tell normal pregnancy nausea from dangerously excessive vomiting, and what to do about HG.  If this tells you that you don’t have HG, hey, there’s something to be grateful for: what you’re experiencing sucks, but it could be worse!

Remember: IT’S ONLY TEMPORARY.  I know, two months is a horribly long time to feel so nasty, and it seems like forever, and many days you feel like you just can’t take it anymore!!!  But it will be over someday.  Even if you are one of the unlucky mothers who suffers from nausea through the entire pregnancy (I had a little of it all the way through the 8th month with Nicholas–but at least it was less after the 3rd month!), eventually you will be done.  Think about this time next year.  Picture your happy, non-queasy self with the adorable baby who will make it all worthwhile!

That’s what works for me when struggling through pregnancy nausea!  What’s worked for you?  Please share in the comments, and feel free to link to your own article on the subject if you have one.  Visit Mom’s Library for more motherly wisdom on many topics.  Visit Waste Not Want Not Wednesday for tips on saving money so you’ll have more to spend on food.