Keep It Down

Tricks for quelling the queasiness of pregnancy and still getting the nutrients you need.


By her third pregnancy, Janet Boggess knew exactly what she had to do: Never leave home without a supply of towels and a fresh stack of plastic bags. And don't go anywhere — especially where food is served — without a lemon. Thus equipped, the 36-year-old pediatric nurse from Nicholasville, Ky., could weather any alimentary storm. Whenever she became overwhelmed by smells — coffee, cigarettes, cooking oils or perfume — Boggess grabbed a lemon and took a bite. And when that sour shock didn't stifle the rising nausea, she was ready with bags and towels to clean up the mess that followed. Morning sickness? Hardly. "It's all-day sickness," says Boggess.

In her misery, Boggess has plenty of company. At least 50 percent of mothers-to-be are afflicted with nausea and vomiting, although most pregnant women suffer far milder symptoms. For many women, morning sickness subsides by the end of the first trimester. But severe or prolonged nausea can cause potentially dangerous weight loss, malnutrition and dehydration.

Ad Nauseum Doctors and dietitians still don't completely understand the queasiness and aversions of pregnancy — or how to prevent them. But it is well-known that hormonal fluctuations play a major role. While any amount of nausea or vomiting is unpleasant, the good news is that for some women, morning sickness may be a sign that all is well. Several studies indicate that women who are nauseated during their pregnancies are less likely to suffer miscarriages or stillbirths than women who aren't.

While the suggestion of a link between nausea and a healthy pregnancy may be reassuring, that doesn't make it easier to live with. That's where Miriam Erick, M.S., R.D., a dietitian at Boston's Brigham and Women's Hospital, comes in. Erick has interviewed more than 1,000 morning sickness sufferers and has written two books and produced videotapes on the subject. Her research suggests that queasy pregnant women can get the nutrients they need from foods they find palatable and are likely to keep down.

Help for the Queasy First, it's important to keep in mind that morning sickness is not just in your mind. "It's in your nose," explains Erick, who says cigarette smoke, perfume and coffee smells seem to be the worst offenders. But cues for morning sickness vary widely from woman to woman, Erick adds, and even from pregnancy to pregnancy.

Comfort foods you have loved for years suddenly may become unappetizing. Boggess, for example, was taking a nap when her husband decided to cook a pot of her favorite chili. The odor was too much — she awoke and quickly became sick.

If you know you need to eat but don't know if you can stomach it, Erick suggests giving in to cravings and eating what sounds good. So you crave only lemonade and potato chips? Go for it, Erick says. "Sweet foods and chips will promote thirst," she adds, which in turn promotes consuming more fluids. And that will help avoid dehydration, one of morning sickness' most serious threats to a healthy pregnancy. It's better to consume a small amount of junk food and keep it down than it is to eat healthy food and lose it before the nutrients can be absorbed.

For many women, eating cold foods can stave off nausea. Alicia Moag-Stahlberg, R.D., who directs the U.S. National Dietary Data Center at Northwestern University, Chicago, recommends a snack of "cold apple slices, eaten slowly," to calm the stomach.

Best of all, look for nutrient-rich snacks. "Why not mix up your own smoothie?" suggests Pamela Lee, R.D., a dietitian at UCLA Medical Center in Los Angeles. "Add yogurt, fruit, low-fat milk and protein powder for a drink that's good for you and easy to [take]." Eating lightly but frequently is another good way to settle the stomach, says Susan Kleiner, Ph.D., R.D., who teaches nutrition at the University of Washington and has a private practice in Seattle. However, drinking too much fluid at mealtime can upset the stomach. Kleiner suggests drinking plenty of liquids between meals and keeping the food you crave and can digest nearby. In the second trimester, sickness usually subsides, so you can get back to minding your nutrients and growing a healthy baby. Until then, don't forget your lemons.