We're all excited to hear that the Duchess of Cambridge is pregnant with her second child. However, once again she is suffering from Hyperemesis Gravidarum - severe morning sickness - and is currently being treated by doctors at Kensington Palace.
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We've been speaking to Robyn Coetzee, Specialist Dietitian at London Bridge Hospital (www.londonbridgehospital.com) about this serious condition and how to reduce symptoms, while limiting the negative impact it might have on a woman's nutritional status during pregnancy.
What is Hyperemesis Gravidarum?
Hyperemesis Gravidarum is a severe form of nausea and vomiting that typically occurs at around 4 - 10 weeks of pregnancy and affects around 0.3 - 1.5% of pregnancies. It is characterised by weight loss, intractable vomiting, electrolyte disturbances and often requires hospitalization. Nausea and vomiting is a common symptom of pregnancy but rarely develops into the more severe hyperemesis gravidarum. Although symptoms may be milder, nausea and vomiting during pregnancy can still be debilitating and have a negative impact on a woman's nutritional status during pregnancy.
What is thought to be the cause?
There are a number of hypotheses such as to what might cause hyperemesis gravidarum such as hormone changes and genetics but currently there is not enough evidence to clearly establish why some women develop this severe form of nausea and vomiting.
Is there a diet plan to follow to minimise nausea?
- Unfortunately there is limited research available to help inform us as to the best diet to treat nausea. Different people find different strategies helpful, but some of the following may help:
- Try to have small, frequent meals and snacks. Having an empty stomach tends to make feelings of nausea worse.
- Keep hydrated. Sip on small amounts of fluids across the day.
- Cold, plain foods are often better tolerated than hot food as these tend to have less of an aroma which can aggravate nausea.
- Avoid fatty, spicy foods.
- Sip or suck on ginger flavoured drinks and sweets.
- Stay out of the kitchen during meal preparation. If possible, ask someone else to prepare meals or make use of ready prepared meals to reduce exposure to aroma during cooking.
- Sometimes drinking and eating at the same time can make nausea worse. Consume foods and fluids separately.
If you are suffering from hyperemesis, how can you ensure that your body is getting all the nutrients and vitamins it needs?
Getting enough nutrition can be difficult when suffering from hyperemesis. It is important to try to keep on top of things early before nausea and poor nutritional intake become a vicious cycle. Trying the above may be helpful, however at times severe nausea and vomiting may make taking anything orally very difficult. It is important that women with hyperemesis seek medical attention as hospitalisation may be required where anti-sickness medication and intravenous fluids may be prescribed. A dietitian can also help to optimise nutritional intake through tailored nutritional advice, nutritional supplements or tube feeding in severe cases.
Will frequent vomiting affect the baby and its development?
A women's body goes through a number of adaptations during pregnancy to ensure optimal growth of the baby. The milder, more common, form of nausea and vomiting during pregnancy is therefore unlikely to have a significant impact on the baby's development. There is however growing evidence that due to the severity and its impact on nutritional status, hyperemesis gravidarum can affect the baby's development. Some studies have found hyperemesis to be associated with a lower birth weight, small head circumference and reduced insulin sensitivity in offspring which can have implications for the long term health of the baby.
What tips would you give to women who have to travel into work on the tube to reduce their sickness?
- Be sure to wear your 'baby on board' badge to help to make the journey more comfortable.
- Take a cold bottle of water or diluted fruit juice to sip on during the journey. This will help to keep you cool and hydrated.
- Take something to snack on if you have a long journey. Long periods without eating can make nausea worse. Plain biscuits, cereal bars and nuts all travel well and can be helpful to nibble on.
- Make sure to wash your hands after travelling and before eating. A women's immunity drops slightly during pregnancy making it easier to pick up bugs and become sick from food contamination.
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