Morning and Daytime Nausea
The term “morning sickness” was reportedly used for the first time in 1803 and has therefore had more than 200 years to stick. A study published in 1918 added weight to this term and indicated the majority of “morning sickness” cases occurred in the morning, disappeared during the day, and returned the next morning, perpetuating the misbelief that an empty stomach was the sole responsible factor.
Researchers now know that approximately less than 2% of women with NVP report symptoms that occur only in the morning. In addition, eating usually does very little to relieve symptoms, especially when severe. Eating, may however, work in women in whom an empty stomach is a contributing factor.
For women who feel sick as soon as they wake up, whether that is 5:00 am or 8:00 am, this can cause considerable anxiety, frustration, and stress.
Feeling nauseous at the start of the day when women cannot hit pause due to employment responsibilities, a commute, childcare, school transportation, pets, and other necessary activities can force some women to essentially throw up and continue moving.
Living through NVP in this way – without a break for rest, sleep, or symptom control – can cause numerous potential complications. Women need to call their HCP if they are having trouble managing their symptoms, which also includes their mental and emotional health, as well as their daytime functioning and ability to sleep at night.
If Eating Helps
If women find that eating right away helps, they should:
Put whatever food item they want to eat first thing in the morning right next to their bed (the night before). If this item is cold (cheese stick, yogurt), women should ask their partner or another family member to grab this item for them first thing in the morning. Women should not limit themselves to “breakfast” foods. Anything that is considered “food” is an option in the morning if it works.
Women can also try putting a small cooler filled with ice next to their bed so they can grab something cold first thing without much help (or movement). Women should fill the cooler as late as possible to make sure it remains cold enough until morning. If the ice has completely melted, and the food item is not cold, they should not eat it (try using frozen water bottles as ice).
Foods that may work first thing in the morning:
A piece of bread/roll in a plastic bag
Banana (sliced may be more preferable; family member can do this)
Apple slices, cheese stick, or yogurt to-go tube
Small amount of potato chips
*A note on crackers: crackers first thing in the morning – or even the middle of the night – likely will not go down well without something to drink. Therefore, if women cannot also drink water, the dry cracker could trigger their gag reflex if their mouth is too dry.
Women could also be nauseous first thing in the morning due to dehydration; it is possible that water or a little bit of juice first thing could also help, which would then allow women to feel better enough to eat something more nutritious.
If women need to eat before even lifting their head, they should eat on their side to avoid choking, or having food fall to the back of throat and triggering their gag reflex.
Women should also consider waking themselves up in the middle of the night to eat/drink something quick to make the early morning nausea less severe. However, this only works when women are not nauseous around 2:00 or 3:00 am; this method would only wake them up and cause them to feel sick the rest of the night (read Evening/Overnight Nausea).
Some women may find that setting their alarm a few hours after going to bed – just to eat – can lessen their nausea at 6:00 or 7:00 am. Women need to use trial-and-error to determine if this would work for them.
Women should wake up, eat something small, and try to go go back to sleep, and at an incline if possible (a few pillows). If they have significant trouble falling back asleep, or feel more nauseated, this method may not be a good option for them. Women should also note that if their symptoms get worse after eating, they may be suffering from acid reflux, a strong contributing factor of NVP.
However, women should not give up on the method too quickly either; it could be that eating would help, but they have to find the right food item/amount that is most optimal.
If Eating Does Not Help
For women who wake up extremely nauseated, logic somewhat dictates that an empty stomach is likely the cause. However, women know themselves better than anyone else – they should not force themselves to eat if it makes them feel worse or initiates vomiting.
In this scenario, women should wake up slowly, move very slowly, and take baby steps to get out of bed. They can take deep breaths, stretch slowly, and then sit up gradually – and just wait. Sometimes even this shift of the stomach can be enough to dry heave or vomit.
The next step could be to slowly sip ice water (or room temperature if preferred). Women should continue sipping water slowly, testing how that works. If the stomach appears to be tolerating it, she can take larger sips of water, continuing to wait. After a few minutes, or longer, women should try to slowly stand and get out of bed, or try a small amount of food (such as the foods listed above).
Managing the Day
Women with morning nausea rarely get an opportunity to stay home for extended periods without having to manage some type of responsibility on top of their symptoms.
Therefore, women should try to manage what they can, change a few schedules when possible, get help from partners, family members, and friends, have a discussion with their supervisor/employer, and learn to cope with anything they cannot control.
These woman should:
Prepare their family (especially with kids) that morning routines may be a bit different for a little while.
Try to get anything ready for the morning during the evening, (or any nausea-free time) that can be done ahead of time – children’s school outfits, work clothes, work emails, school lunches packed, breakfasts ready to go, pet care, backpacks packed and by the door, etc.
Keep a log to determine if dinner, nighttime routine, medication, other management methods, or amount of sleep affects their nausea in the morning.
Avoid getting out of bed too quickly; they should take their time, to include slow stretches. Women can change a few positions slowly to “test” their nausea level. If they feel okay, then they can attempt to get up and possibly walk around. If not, they should move slower and wait.
Capitalize on their late afternoons and evenings if this is when they feel their best; they can plan most activities for this time frame (social events, homework, work, errands, chores), to include catching up on food and fluids.
Ask their partner, other family members, or a neighbor/close friend to walk their dog(s) or to take care of other pets if necessary.
Avoid any and all triggers; women should ask their partner/family members to avoid cooking anything in the morning that could trigger vomiting.
For women who work first thing in the morning or during the day, they can prepare their supervisor they may need to arrive later on some days, require a shift change, telework in the mornings, or flex their hours due to NVP.
However, this conversation can be very difficult for women to have with their supervisor, especially if they do not want to announce their pregnancy to anyone just yet.
Women need to consider the risks and benefits of letting their supervisor know they are pregnant. Employers are required to provide reasonable accommodations for pregnant women with a medical condition (such as NVP); therefore, although telling a supervisor may not be ideal, it could provide much needed flexibility to manage early morning symptoms. Read more.
Women can prepare their car/purse for their commute, whether they drive themselves, take public transportation, or have a friend/co-worker drive. They can also prepare their work station and place of employment for combating NVP while at work (read more).
Living through NVP – without a break for rest, sleep, or symptom control – can cause numerous potential complications. Women need to call their HCP if they are having trouble managing their symptoms, which also includes their mental and emotional health, as well as their daytime functioning and ability to sleep at night.
Morning and daytime nausea and vomiting can affect every aspect of a woman's life, change her family dynamic, and add employment-related stress.
Women should try numerous management techniques at the same time – under close supervision with their HCP – and understand that using or needing medication is not a failure. There are many effective first-line medications that are safe during pregnancy.
Women no longer have to suffer through NVP without help. Further, taking complete control over symptoms early in pregnancy instead of simply waiting them out can improve their physical, mental, and emotional health for their entire pregnancy.
Women should also consider sharing their NVP experience (below), especially how they felt, how long it lasted, what may have caused or contributed to their symptoms, and anything they did that relieved symptoms, even if only temporarily. Further, women should offer any management strategies that helped them manage their morning/daytime nausea.
When women suffer early morning and daytime nausea, it could put their entire day at a standstill. Any type of responsibility is extraordinarily difficult when the threat of vomiting is always close. Further, nausea can affect a woman's ability to pack school lunches, prepare breakfast, get dressed and drive to work, etc.).
Women with morning nausea need to eat "RIGHT NOW" when they wake up, and any type of movement may make them vomit. It can be a very difficult feeling to describe.
If the woman has asked her partner to bring them something cold in the morning, partners should understand they should do this as soon as she asks. Women can start gagging or dry heaving relatively quickly.
Partners should read everything they can on this site about this condition. When they have a better understanding of NVP symptoms, complications, duration, severity, and management, they are in a better position to not only be a better physical source of support, but emotionally as well.
Nausea and Vomiting of Pregnancy: Committee Opinion 189; January 2018 (American College of Obstetricians and Gynecologists)
Morning Sickness: Nausea and Vomiting of Pregnancy (American College of Obstetricians and Gynecologists)
Pregnancy sickness (nausea and vomiting of pregnancy and hyperemesis gravidarum) (Royal College of Obstetricians and Gynecologists)