Diet and nutrition
Most women suffering from sickness in pregnancy find that bland carbohydrates, such as rice, baked potatoes, pasta, scones, bananas, rusks, porridge and dry toast, are foods that they can tolerate. ‘Little and often’ is the rule, and such foods should be taken every hour or two, for instance snacks of fruit and seeds. This way they can avoid the daunting prospect of a full meal, while maintaining a reasonably steady blood sugar level. It has also been suggested that taking drinks separately from meals is likely to make a sufferer feel less sick.
It is quite acceptable to indulge cravings, even though women may feel guilty that some of the food they are eating is unhealthy. It is important to carry on eating adequately, and it is much worse if a patient chooses to eat nothing than the ‘wrong’ thing.
It is thought that morning sickness may be indicative of small nutritional deficiency in vitamins and minerals. Vomiting will further deplete reserves, and a vicious circle of cause and effect can set in. The following nutrients are very much important
Vitamin B deficiency is associated with anxiety, malaise and depression. There has been controversy about B6. Even so, for women who have suffered from hyper emesis in the past, it is a good idea to boost intake of vitamin B6 before attempting another pregnancy. If taken in doses of 25 mg orally, every 8 hours for 72 hours, this has been shown to have a significant effect, reducing nausea and vomiting in women with severe pregnancy sickness symptoms. A double-blind randomized controlled trial of 59 women showed that it helped those whose nausea and vomiting symptoms rated more than 7 on a scale of 0–10, but it was no more effective than a placebo for those who were not badly affected. The most recommended dosage in pregnancy is 100 mg daily but it is preferable to take B6 as part of a B complex, because B6 taken in isolation can upset the balance of the other B vitamins. Good food sources to keep up B6 levels are sesame seeds, chick peas, bananas, sweet corn, raisins and hazelnuts.
Magnesium stores are diminished by vomiting, and magnesium deficiency can exacerbate nausea so that magnesium-rich foods such as nuts, pumpkin seeds, beans, wheat germ, avocado and broccoli can be important in the diet.
In the same way, potassium can be diminished, and potassium-rich foods include dried apricots, bananas, melons, figs and fruit juices such as orange and pineapple.
Zinc requirements increase during pregnancy, and zinc deficiency is also associated with nausea. Zinc is required during pregnancy for the growing tissues of both mother and baby, so there are extra demands on the mother’s supply. If a woman goes into pregnancy deficient in zinc, she is more likely to experience nausea, especially if she has used a contraceptive pill before getting pregnant. In particular, ginger is a rich source of zinc. It improves motility in the gastrointestinal tract so that food passes more rapidly, and is considered to have absorbent properties which may cut stimuli to the chemo receptor area of the brain which sends messages to the emetic center. Doctors tell patients to take a ginger capsule four times a day.