Pregnant woman experiencing morning sickness
13 July 2015

Living With Morning Sickness: Are There Choices Other Than Zofran?

According to most pregnancy experts, as many as 90% of all pregnant women will experience nausea and vomiting at some point in their first trimester. And while this common symptom has been labeled “morning sickness,” it isn’t limited to the hours before noon. The Mayo Clinic reports that the nausea and vomiting of pregnancy (NVP) “can strike at any time of the day or night,” and BabyCenter goes so far as to say that “morning” sickness lasts all day long for the majority of pregnant women who experience it.

NVP is most common during the first trimester, but some women will experience nausea and vomiting throughout their pregnancies.

6 Strategies To Beat Morning Sickness Naturally

Pregnant woman experiencing morning sicknessFor some women, those experiencing severe nausea and vomiting, medical intervention becomes necessary. But if you’re experiencing mild morning sickness, some simple lifestyle alterations may be able to keep your nausea at bay.

According to BabyCentre, here are 6 lifestyle changes that may be able to alleviate the symptoms of nausea and vomiting during pregnancy. Please speak with your doctor, midwife or OB / GYN before trying any of these strategies yourself; some changes may not be appropriate in your situation.

  1. Many pregnant swear by ginger, a root that has been added to teas for centuries to soothe upset stomachs. Try nibbling on ginger snaps, drinking ginger ale or sucking on a ginger lozenge.
  2. Rather than eating three large meals a day, try smaller portions at more regular intervals. Sometimes eating anything can be difficult. If you’re experiencing food aversions that steer you away from healthy options, that’s okay. Stick with what you can stomach. Once your nausea eases, you can try gradually adopting a balanced diet again.
  3. Hydrate, hydrate, hydrate. This is something almost everyone will suggest, and for good reason. Try plain water, or a sports drink like Gatorade to replenish your body’s supply of electrolytes, which can be depleted if you’ve been vomiting. For women who are having trouble keeping anything down, sucking on ice chips might be a little easier.
  4. Vitamin B6, found in most prenatal vitamins, may be able to ease the symptoms of morning sickness, according to the US National Library of Medicine. If you’re already taking a prenatal vitamin, you could try taking it at night rather than in the morning. Most prenatal vitamins contain iron, which can irritate your stomach.
  5. Acupressure, an ancient therapeutic method that involves applying gentle pressure to specific points on the body, is gaining traction as an effective morning sickness remedy. There’s even a product, Sea Band, that can press the right pressure point for you.
  6. Scent is a huge nausea trigger for many pregnant women. Try eating colder foods, or allowing your hot food to cool more than usual, which will reduce odors.

What Causes Morning Sickness?

Researchers still haven’t found the precise cause of pregnancy-related nausea yet, but many believe that rising levels of human chorionic gonadotropin (HCG), a hormone that growing placentas release, may be involved. Turns out that HCG is essential to the development of healthy babies, but higher concentrations seem to result in more morning sickness.

In fact, a recent study published in the journal Reproductive Toxicology found that women who experienced morning sickness were less likely to miscarry. NVP was also linked to a reduction in the risk of birth defects and premature births.

Hyperemesis Gravidarum

Hyperemesis gravidarum (HG) is the most severe form of morning sickness: constant nausea and severe vomiting. For some women, HG lasts throughout pregnancy. When left untreated, HG can lead to significant adverse effects, including:

  • unsafe weight loss
  • electrolyte and nutritional imbalances
  • severe dehydration
  • fatigue

Hyperemesis gravidarum can also increase the risk for adverse fetal outcomes, and some women suffering from HG may need to be hospitalized.

Physicians can employ a wide range of treatment options to combat severe morning sickness, including nutritional therapy and IV hydration. But the most common treatment is through the prescription of anti-vomiting, or anti-emetic, drugs.

Common Drugs Prescribed To Treat Morning Sickness

Before we cover some of the more common prescriptions used to treat nausea and vomiting of pregnancy, it’s crucial that we first mention that only one prescription drug is currently FDA-approved as both safe and effective for the treatment of morning sickness. Diclegis, sold as Diclectin in Canada, is a combination of doxylamine succinate, an antihistamine, and pyridoxine hydrochloride, a type of Vitamin B6. The FDA’s approval of Diclegis, in April of 2013, indicates that the agency has reviewed and accepting clinical trial data demonstrating Diclegis’ safety, for both mothers and their unborn children.

With that being said, physicians continue to prescribe many drugs “off label” to pregnant women suffering from morning sickness. “Off label” means that the drug has not been approved for use during pregnancy, and there may be a lack of adequate scientific research demonstrating its safety or efficacy for pregnant women.

Off Label Drugs Prescribed For Nausea & Vomiting Of Pregnancy

Antihistamines, like over-the-counter drugs such as Benadryl or Dramamine, are thought to prevent your ears from responding to motion and changes in balance, both of which are linked to sensations of nausea. Some doctors prescribe antihistamines to alleviate the symptoms of morning sickness.

Corticosteroids are often used to prevent nausea and vomiting in cancer patients undergoing radiotherapy or chemotherapy. In recent decades, they’ve come into common use as a treatment for severe morning sickness, too.

Serotonin antagonists, including ondansetron, are believed to block the action of serotonin, a neurotransmitter thought to trigger a portion of the brain that controls nausea. As with corticosteroids, most serotonin antagonists are only approved to treat limited patient populations experiencing nausea and vomiting, like chemotherapy patients and surgical patients receiving anesthesia.

Zofran & Pregnancy: Is This Common “Off Label” Morning Sickness Treatment Safe?

Kytril and Anzemet are two serotonin antagonists that physicians have turned to for the treatment of NVP, but another drug, Zofran, has quickly become America’s leading morning sickness remedy. Experts have estimated that more than 1 million “off label” Zofran prescriptions are written every year to pregnant women.

But Zofran’s safety for developing babies has come into question in recent years. First, a study conducted by researchers at Harvard and Boston Universities found that women prescribed Zofran’s active ingredient during the first trimester were more than twice as likely to deliver babies with a cleft palate. Then multiple teams in Sweden and Denmark linked prenatal exposure to Zofran with an increased risk for severe congenital heart defects.

On the heels of these study results, some families have begun to file Zofran birth defect lawsuits. Plaintiffs claim that ingesting Zofran during early pregnancy caused their unborn children to develop severe birth defects. In fact, these parents allege that Zofran’s manufacturer has been unlawfully promoting the drug as a “safe and effective” morning sickness treatment for years, even in the face of mounting evidence that Zofran may cause fetal harm.

At least 10 families have added their voices to this growing litigation, but with so many women having been prescribed Zofran during the first trimester, legal experts expect the number of claims to increase quickly. In the meantime, many pregnant women have started to look elsewhere for a morning sickness remedy.

Always consult with a trusted health care professional before beginning to take, or discontinuing, a new prescription drug, especially if you are pregnant.