Evidence-Based Approaches to Managing Nausea and Vomiting in Early Pregnancy

Tekoa L. King, CNM, MPH; Patricia Aikins Murphy, CNM, DrPH


J Midwifery Womens Health. 2009;54(6):430-444. 

In This Article

Dietary and Lifestyle Recommendations

Dietary and lifestyle changes are common first-line approaches for the woman with mild NVP. These include taking only small amounts of liquid or food at a time at frequent intervals; avoiding an empty stomach; avoiding rich, fatty, or spicy foods (even smelling or cooking these types of foods); eating dry crackers before getting out of bed in the morning; and eating a high-protein snack before retiring at night. There has been no evidence-based research on the effectiveness of these approaches, although their safety is not in question. In one survey, women reported that these measures help, but few women report complete relief and most do not rank them high in importance for alleviating their symptoms.[9,31] In a recent international survey by Goodwin et al.,[32] 22% of women who had HG stated that dietary interventions were either maybe effective or effective.

One randomized trial and an observational study found that taking a general multivitamin before pregnancy and/or before 6 weeks' gestation is associated with a decreased incidence of NVP.[33,34] No clinical trials have directly tested the use of multivitamins as a preventative treatment for NVP. Conversely, the iron in prenatal vitamins is known to cause gastrointestinal symptoms in some women, and therefore one of the first treatments clinicians often suggest for women with NVP is to discontinue the prenatal vitamin until the NVP is resolved.


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