When Pregnancy Sickness Becomes Far Too Excessive

Women whose pregnancy sickness is normal but includes regular vomiting tend to lose some weight during the first trimester. At what point should a woman become concerned that she has too much pregnancy sickness? If she loses more than 5 percent of her body weight (for example, if she weighed 120 pounds before pregnancy and drops below 114 pounds) she should alert her OB/GYN or midwife.

If vomiting becomes unrelenting and prevents her from keeping down any food, she should alert her OB/GYN or other health care provider immediately, because she probably will need to receive fluids and electrolytes intravenously. Her OB/GYN or other health care provider also will need to perform tests to rule out the possibility that her vomiting is due to a medical condition unrelated to pregnancy sickness, such as appendicitis, hepatitis, infectious diarrhea, urinary tract infection, peptic ulcer disease, gall bladder disease, kidney insufficiency, liver disease, hyperthyroidism, inflammation of the pancreas, or diabetic ketoacidosis.

If a woman's pregnancy sickness is so severe that the smell of virtually every food sickens her, she should try to eat in ways that, as much as possible, bypass her sense of smell. For example, one thing she could try is the following: blend very fresh milk and fruit with ice (the cold helps suppress the odor); pour the mixture into a glass; cover the top of the glass tightly with plastic wrap; poke a straw through the plastic; then take small sips every few minutes. Juices can be diluted with water to make their odors less intense. Drinking diluted juice out of a baby bottle also can help to suppress the juice's odor.

A woman with hyperemesis gravidarum is likely to have more success keeping food down if she eats frequent meals consisting of small amounts of nonoily foods (oils are difficult to digest). If a woman is vomiting frequently, it is extremely important that she replenish lost fluids. Drinking liquids at meals, however, may make her stomach feel too bloated, which could exacerbate nausea. Most OB/GYNs and midwives therefore recommend drinking liquids between meals. But a pregnant woman who is losing a lot of weight may want to resort to liquid meals, such as clear broths or one of the high-calorie liquid nutritional supplements intended primarily for the elderly or for chemotherapy patients. Salting her foods to taste can help replace two of the important electrolytes - sodium and chloride - that her vomiting may have depleted.