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Some natural remedies can be tried at home, while alternative therapies require finding a qualified provider with experience treating pregnant women.
Taking vitamin B6 (also known as pyridoxine) has been shown to relieve nausea in some pregnant women. It's not clear why, though.
Before taking vitamin B6, check with your provider to find out how much to take and whether the amount in your prenatal vitamin counts as one of the doses.
Your provider may suggest that you start by taking 10 to 25 mg, three or four times a day.
Don't take more B6 than your provider recommends. Too much can cause numbness and nerve damage for you and may not be safe for your developing baby.
You may also be able to get enough vitamin B6 by simply eating a varied and nutritious diet, since it's found in a wide variety of foods (see food section above).
Medicine for morning sickness
It's best to try nondrug options first so that you don't expose your developing baby to medication unnecessarily. But if natural remedies don't help, ask your provider about anti-nausea medicines. Several supplements and drugs – in both pill and suppository form – are considered safe to take for morning sickness, although not all of them work for everyone.
Over-the-counter (OTC) treatments for morning sickness
- Vitamin B6 (see above). The American College of Obstetricians and Gynecologists (ACOG) considers this a first-line treatment for morning sickness.
- Antihistamines such as doxylamine are also used to treat nausea and vomiting during pregnancy. Doxylamine is available over the counter as a sleeping pill, so it could make you drowsy – don't drive after taking doxylamine.
- Combination vitamin B6 and doxylamine is also recommended by ACOG as an initial treatment for morning sickness. This combination is considered safe and is sold under the brand name Diclegis. Your provider may prescribe Diclegis or recommend an OTC combination.
- Reflux medicines such as Zantac or Pepcid sometimes work if your nausea is triggered by stomach or intestinal problems.
Prescription medicine for morning sickness
Your provider may prescribe one of the medications below if other treatments aren't effective. There's limited information about the safety of these drugs during pregnancy, so your provider will weigh the risks and benefits carefully:
- Metoclopramide (Reglan)
- Promethazine (Phenergan)
- Prochlorperazine (Compazine)
- Trimethobenzamide (Tigan)
- Ondansetron (Zofran): Safety data on ondansetron has been inconsistent. Some studies suggest ondansetron is linked to a slight increase in the risk of cleft palate or heart defects in babies born to women who took the drug during early pregnancy. Other studies have found an overall low risk.
Your provider will consider the risks and benefits before deciding whether to prescribe ondansetron. Some experts suggest using ondansetron only if no other treatments have worked.
Medicine for hyperemesis gravidarum
If your nausea and vomiting are so severe that you can't keep anything down, you're dehydrated, and you're losing weight, you may have hyperemesis gravidarum, a severe form of nausea and vomiting during pregnancy. In this case, your provider probably will want you to be treated in the hospital with intravenous (IV) fluids and medications.
IV drugs to treat hyperemesis gravidarum include antihistamines, dopamine antagonists, serotonin antagonists, chlorpromazine, and glucocorticoids. These are often given along with fluids, vitamins, and minerals under close medical supervision.
If no other treatments work, your provider may suggest trying a subcutaneous pump. This involves inserting a small tube under your skin to slowly pump medication into your body throughout the day.
However, there's not a lot of research on how well this works, and you could have minor complications, such as skin irritation or tenderness where the tube was inserted. Discuss the risks and benefits with your provider.
Is it safe to take diphenhydramine (Benadryl) for morning sickness?
Most research suggests that Benadryl is safe to take during pregnancy. Your provider may recommend diphenhydramine if you still have morning sickness symptoms after trying nondrug options as well as vitamin B6 (with or without doxylamine).
The U.S. Centers for Disease Control and Prevention (CDC) reviewed more than 50 studies to see if there was a higher risk of birth defects after using antihistamines such as Benadryl during pregnancy. Most of the data was reassuring, however, a few studies showed a potential link between diphenhydramine and certain birth defects.
One study by UCLA researchers found that women with severe morning sickness (hyperemesis gravidarum) who took antihistamines such as Benadryl during pregnancy were at higher risk for premature birth or having a low-birth-weight baby.
Scientists continue to study the safety of antihistamines during pregnancy. As with any drug, it's important to consult with your provider before taking Benadryl or other medications while pregnant.