Archive for the ‘Morning Sickness’ Category
January 12th, 2010
Until yesterday, I didn’t spend my time thinking about the connection between peanut butter on toast and acupuncture; however, something happened to enlightened me.
Two women came in for their second appointment yesterday. Both were suffering from nausea (and in one case projectile vomiting). One was 20 weeks pregnant. The other 34 weeks. Both had dramatic responses to their first acupuncture treatment, and whereas they were unable to eat much previously, both commented that their appetite had improved, and in particular, that they were craving peanut butter on toast.
Both women are examples of “morning sickness” being poorly named (it’s rarely just in the morning), and unfortunately for them, they are examples of women who did not enjoy relief after 12-14 weeks gestation. They have both given me permission to share some of their story. Of course, their stories continue to unfold.
Karen
37 years old and pregnant with her second child, Karen came for acupuncture for nausea and headaches which were worse in the afternoon and evening. Her symptoms began in early pregnancy, but became worse after 14 weeks gestation. She came to see me at 20 weeks. Karen often has to lie down in the evenings with throbbing pain in her whole head and is suffering from sinus congestion. Karen stood up from her first treatment to find that the nausea and headache were gone. She was in a great mood, was breathing easier, and had a good appetite. She enjoyed 4 days symptom free. On the 5th day her symptoms started coming back and she called to book a second appointment. After the second treatment, Karen once again felt great. I suggested Karen come back in 1 week. I am very pleased with her response, but of course, not as pleased as she is.
Jennifer
Jennifer called me for a housecall at 34 weeks. She is 34 years old and pregnant with her second child. Her first child was born at 36 weeks gestation and her primary caregivers anticipate that is likely she will go into early labour this time as well. Jennifer looked to acupuncture for pain relief- particularly a pain below her right ribs. She also was suffering from daily vomiting. She was bringing up most of what she had eaten in a given day, which was particularly concerning on a background of extremely low iron, with accompanying exhaustion and intense heartburn. Jennifer came to my office for her second acupuncture treatment to report that she had not vomited since the first treatment (5 days! which may not seem like a long time for most people, but was a huge relief for her). We discussed prioritizing pain relief and supporting her “blood” (in Chinese Medicine, blood deficiency is related to but not limited to low iron counts). Jennifer is scheduled for an IV iron treatment tomorrow. Her situation offers an example of how acupuncture can be used as a complement to other interventions. Now that she is beginning to feel better and not vomit, Jennifer will likely gain strength and nutrition to support her in labour and postpartum.
I hope connections like “acupuncture and Peanut Butter on Toast” continue to bring relief to pregnant women around the globe. Hungry anyone?
January 1st, 2010
Here are more self help suggestions for Nausea and Vomiting in pregnancy (NVP). Aside from acupuncture, different things work at different times and for different people, so it’s helpful to have lots to try…
Here’s a list I got from a friend:
24 WAYS TO EASE MORNING SICKNESS
1. Avoid nausea triggers. The most common offenders include body odors, stale or leftover food in the fridge, coffee, gasoline, solvent fumes, garbage, scented cosmetics and toiletries, and pungent aromas of cooking foods.
2. Make “designer” days. Compare your good and bad days. As much as humanly possible, design your day to avoid the known triggers. If wet dog smells or litter box stench gets to you, let someone else get them out of your way. Warning! During pregnancy, avoid cat feces because they may contain toxoplasmosis bacteria, which can cause serious damage to the baby.
3. Eat before your feet hit the floor. If you start the morning off sick, you are likely to stay sick all day. Set a tray of easy-to-digest favorites at your bedside. When you awaken to trek to the bathroom in the middle of the night, treat your stomach to a nibble or two. Continue to munch all morning, carrying your nibble tray around with you, if necessary—yes, even in the car and by your desk at work.
4. Ease into your day. If you don’t have to awaken at a set time, don’t. Ask your mate to get up quietly without disturbing you, and slowly awaken in your own time.
5. Graze to your stomach’s content. Low blood sugar can trigger nausea, and it may occur upon awakening or anytime you go hours without food. Grazing on nutritious mini-meals throughout the day keeps your stomach satisfied and your blood sugar steady.
6. Nibble, nibble and nibble on stomach-friendly foods. Because high- fat, spicy, and some high-fiber foods are harder to digest, consume easily digestible foods, such as liquids, smoothies, yogurts, and low-fat, high-carb foods. Avoid hard-to-digest fatty foods and fried foods, such as premium ice cream, french fries, and fried chicken.
7. Eat nutrient-dense foods. Include avocados, kidney beans, cheese, fish, nut butter, whole-grain pasta, brown rice, tofu, and turkey. If peanut butter is too strong, try almond or cashew butter, and spread it thinly on crackers, bread, apple slices or celery sticks; a large glob of it may bounce back due to its high fat content.
8. Avoid dehydration by eating foods that stimulate thirst. Remember the three Ps: pickles, potato chips, and pretzels. Avoid letting your saliva hit an empty stomach. An empty stomach is hypersensitive to saliva, and nausea will soon follow. Line your stomach with milk, yogurt or ice cream before eating a saliva-stimulating food (such as salty foods, or dry foods such as crackers). Try peppermint candies or gum to help nausea but not on an empty stomach, and chew gum, containing sugar to avoid chemical sweeteners. Eat foods with a high water content to ease dehydration that aggravates nausea. Include melons, grapes, frozen fruit bars, lettuce, apples, pears, celery, and rhubarb.
9. Take prenatal vitamins with your biggest meal to prevent nausea. Vitamins can be a big trigger of nausea—unless they are taken with a large meal.
10. Eat high-energy foods. Complex carbohydrates (grandmothers called them starches) act as time-release energy capsules, slowly releasing energy into your bloodstream and helping to keep your appetite satisfied. The main food group represented here is grains (rice, corn, wheat, oats, millet, barley), found in breads, cereals, pastas, and crackers.
11. Stick to feel-better favorites. Make a list of foods that help you feel better or less nauseated. While this list may change, it can help you avoid food triggers that make you ill.
12. Make yourself eat. No matter whether you feel like it or not—eat something. If you don’t eat, you will get an acid-filled stomach and low blood sugar.
13. Get out and see the world. Visit friends, go to a movie, rest in a hammock, take a walk at lunchtime, or go to a park with friends. Any change of scenery may provide a stomach-settling distraction.
14. Drive, don’t ride. Some women find that by doing the driving instead of riding, they have less of a nausea problem. This explains why the helmsman on a boat is the least likely to get seasick.
15. Delegate, delegate, delegate. Delegate tasks to Mr. Mom or to older kids. Post a list of “these things bother mom…these things make me feel better.” Let your spouse mop the floor. Cook easier meals. If the entire family eats cheese and crackers and carrots for a few meals, they will survive.
16. Plan ahead. If you know what makes you miserable, arrange for detours around the things that trigger nausea. Follow this checklist:
• If cooking odors bother you, consider pre-cooking and freezing foods on days you feel well.
• Buy more convenience foods.
• If you are invited to another home for dinner, offer to bring a dish you know you’ll be able to eat.
• Carry your reliable edibles with you; when a hunger surge hits, the nausea is sure to follow if you don’t have a tried-and-true tidbit handy.
17. Reduce stress. Prenatal researchers feel it’s better for a baby in utero to be spared a steady barrage of stress hormones—and stress can increase your nausea cycle. Learning to reduce stress now is good practice for maintaining serenity as a new mother. Remind yourself that what your baby needs most is a happy, rested mother, both before and after birth.
18. Try acupressure. Both Eastern and Western medical practitioners describe a pressure point about two inches above the crease on the inner aspect of the wrist which, if stimulated, may relieve nausea and vomiting associated with pregnancy and other conditions (such as seasickness). Sea Bands®, available without prescription at pharmacies and marine stores, are worn around one or both wrists. Each band contains a button that presses on the vomiting-sensitive pressure point. These bands have been shown to work in research studies.
19. Dress comfortably. Wear loose clothing. Many mothers find that anything pressing on their abdomen, waist, or neck is irritating and nausea triggering.
20. Position yourself for comfort. Heartburn is another common part of the nausea-pregnancy package. This burning feeling, which is caused by reflux of stomach acids into the lower esophagus, occurs more frequently during pregnancy (hormones, again, which relax the stomach walls). For heartburn, keep upright or lie on your right side after eating. Lying on your back is more likely to aggravate heartburn.
21. Sleep it off. It’s fortunate that the extreme need for sleep coincides with the morning sickness phase. So precious is this rest that you will want to ensure that sleep goes on as long as possible.
22. Have one last meal before retiring, preferably of fruit and long- acting complex carbohydrates (grains and bland pasta). These foods slowly release energy into your bloodstream throughout the night yet are unlikely to keep you awake. Add to these natural antacid foods—milk, ice cream, and yogurt— to neutralize upsetting stomach acids as you drift off to sleep. Take chewable calcium tablets, which act as antacids, before retiring or upon awakening.
23. Eat anyway! While it’s not uncommon for women to feel that nothing tastes good, not eating can actually aggravate the cycle of nausea.
24. Be positive. Lastly, choose who you share your misery with. Mothers who have been there and felt morning sickness will understand; others won’t. When you’re having a day you can’t keep anything down, keep your eyes on the prize—the precious baby-to-be!
SAY ‘YES’ TO TUMMY-FRIENDLY COMFORT FOODS
Applesauce
Avocado
Bagels
Cereal
Chewing gum
Frozen yogurt
Ginger, available as root extract, fresh ground, capsules, tea, sticks, crystals, or snaps
Grapes
Lemon drops
Lemons, for sucking on or sniffing
Mints, peppermint
Oatmeal
Potato chips
Potatoes (baked, boiled, mashed)
Puddings
Raspberry leaf tea
Rice cakes
Soda crackers
Sorbet, sherbet
Yogurt smoothies
SAY NO TO DISCOMFORT FOODS
Cabbage
Cauliflower
Coffee and cola
Foods containing monosodium glutamate (MSG)
Fried eggs
Fried foods
Greasy foods
High-fat foods
Onions
Sauerkraut
Sausages
January 1st, 2010
Nausea and Vomiting in Pregnancy (NVP) – Self-Care Guide
Congratulations on your pregnancy! The good news is that morning sickness can be a sign of a healthy pregnancy. The difficult part is that it can make it hard to enjoy being pregnant, and sometimes even to get out of bed!
Below are some suggestions of ways to take care of yourself. Not all suggestions will be of interest to everyone and acupuncture for pregnancy is not always the first course of action, but I hope that you will find some suggestions that bring relief and comfort.
1. Rest and Relaxation
Your body is doing a tremendous amount of work – consider that the fetus and placenta are entirely developed by 12 weeks gestation (all systems have developed, ready to grow and mature), so it is understandable that your body needs some extra rest. When exhausted, a woman is more prone to suffer from nausea and vomiting. Enjoy guilt free afternoon naps and going to bed early.
2. Little and Often
Eat frequent and small meals to keep blood sugar levels stable. A small snack every 1-2 hours is recommended (avoid sugary foods). All women want to eat well for themselves and their babies, but often morning sickness makes many of the dream foods unpalatable. Eat what you can. Don’t worry if that means lots of crackers and white bread. The fruits and vegetables will come when you start feeling better.
Hunger makes nausea worse. The key is to snack throughout the day. Try to eat nutritious foods, but also respect your body’s limits and messages. Try protein rich snacks (e.g. Nuts, yogurt, bread and tihini, brown rice with miso, fish or lean meat) before bed. Increase your protein, iron and vitamin B intake and avoid spicy and greasy foods. Some recommended foods include:
Almonds, rice, crackers, dried fruit (especially apricots and raisins), egg sandwiches, grapefruit, yeast extract, miso, noodles, peaches, pears, peppermints, potatoes, white bread, yogurt, baked vegetables, and soups- especially potato soup and rice congee.
3. Drink up
Drinking plenty of water is good for us all the time. Women experiencing morning sickness benefit from drinking between meals (drinking with meals can increase nausea). The key is to stay hydrated. Dry lips, feeling thirsty and scanty or infrequent urination are signs that fluid intake is inadequate.
You can also get lots of water (along with valuable nutrition) by drinking herbal teas.
Ginger root tea relieves nausea for many women. A study* comparing the effectiveness of ginger root tea with vitamin B6 found no significant difference between the two, with all women having reduced nausea, retching and vomiting at 7, 14, and 21 days of participation.
Raspberry Leaf tea is a pregnancy tonic that many women find brings gentle relief of nausea and stomach distress. This tea has a rich concentration of vitamin C, the presence of vitamin E, and the easily assimilated calcium and iron, in addition to vitamin A and B complex as well as many minerals, including phosphorus and potassium.
Peppermint or Spearmint tea These fragrant teas can bring relief and settle the digestion of those sensitive to smells.
Making a herbal infusion: use a jar that has a lid and holds at least 4 cups of water. Put one handful of loose leaves (or roots in the case of the ginger) and pour boiling water into the jar. Leave for 4 hours or more (it’s easy to prepare this before bed and have it ready room temperature in the morning).
Long steeping extracts all the chlorophyll, as well as the vitamins and minerals. Drink over the course of the day.
If you want to steep a fresh hot cup of tea, leave a teaspoon of herbs in a cup of water for at least 15 minutes.
4. Visualize
The digestive tract is meant to have a downward motion (you eat, food goes down to your stomach to be digested and then down to the intestines to be absorbed and evacuated). Nausea and vomiting are examples of upward motion, in Chinese Medicine terminology this is called, “counter flow of Stomach energy”.
Visualization can re-establish downward flow (this is also largely the benefit of acupuncture treatment for morning sickness).
I like to imagine I am standing under a beautiful natural waterfall. I feel the water gently falling onto my head and then flowing across my shoulders and down my body. My feet are solid on the ground in pools of water. This water is absorbed into the ground.
This visualization can be done standing up or sitting down (with feet flat on the floor). Imagine warm sun and cool refreshing water. Breathe deeply with this image in mind for a couple minutes.
5. Touch
Any loving supportive touch can be very soothing and relieving. Try downward strokes along your arms or legs. Have someone massage your feet if you can’t reach them comfortably yourself. A special pressure point for nausea is called “P6” in Chinese medicine. To find it, put three fingers along this inside of your forearm, with one finger directly above the upper crease of your wrist. In the middle of the forearm at the spot where the third finger rests you will find a sensitive point if you press with firm pressure with your thumb. This technique has been used for thousands of years to bring relief of nausea. Press into the spot and maintain pressure while you take 4 breaths and then release and repeat; or you can apply the pressure with the breath – pressing into the point when you breathe out and coming off the point when you breathe in. See which ways feels better to you. Repeat for 5 minutes every couple hours.
6. Exercise and Fresh Air
Even if you don’t initially feel like doing much, exercise like walking, tai chi and yoga have been found to make women feel much better once they get started. A gentle push out the door may make all the difference in the world.
Good luck and congratulations!
December 27th, 2009
Does acupuncture really help women with Morning Sickness?
I have worked with dozens of women with Morning Sickness over the past 13 years. Some women have immediate dramatic improvements, while others do not. Most women find that acupuncture, in combination with lifestyle and dietary modifications, improves their quality of life and is a welcome support.
Here are two very different stories of women that I have worked with:
Rosa- “Rosa” was a social worker pregnant with her second child. She was working full time and had a two year old son. Rosa was 10 weeks pregnant and had been constantly nauseated from the beginning of the pregnancy. She continued to force herself to work, with regular visits to the washroom to vomit. She was able to eat small meals, though often had to throw up soon after eating. She had never tried acupuncture before and had been encouraged to come by her sister-in-law. During the treatment, Rosa allowed herself to relax and to cry. She was exhausted and scared. When she stood up from the treatment, Rosa’s nausea was gone. She was thrilled. She began a pre-planned holiday the following day. I spoke with Rosa after her holiday to learn that the nausea did not return. She was doing well and had cut down on her work schedule. I did not see Rosa again, but was told that her pregnancy and birth were healthy and happy.
Dana – “Dana” saw me weekly throughout her pregnancy starting at 28 weeks. This was here third pregnancy in which she suffered from hyperemesis. It was difficult for Dana to get out of bed without being overwhelmed with nausea and vomiting. A care worker was called in to help her with her children. She was taking a large dose of Diclectin which did take the edge off somewhat but did not stop the symptoms. After we began regular acupuncture treatments, Dana rarely vomited. Her nausea subsided for a day or two after treatment, but regularly returned. Acupuncture was a welcome short term relief and helped her to feel well enough to eat more and enjoy her children. Dana was still nauseated throughout labour. She told me that she felt the nausea lift at the moment that her placenta separated (and was then born). She remembered feeling the same way at her previous birth.
Research
Dawn Aarons, Acupuncture Therapist in Toronto, Canada was interested in the following acupuncture research which she wishes to share:
Research conducted in Australia in 2002 concludes that “acupuncture is a safe and effective treatment for women who experience nausea and dry retching in early pregnancy”. Here are more details about these studies:
Smith et al. in 2002 published two articles from their research on nausea and vomiting in pregnancy. The first looked at the effectiveness of acupuncture and the second at the safety of acupuncture treatment in early pregnancy.
Summary
The objective was to compare i. traditional acupuncture treatment, ii. acupuncture at Neiguan P-6 only, iii. sham acupuncture and iv. no acupuncture treatment for nausea and vomiting.
593 women who were less than 14 weeks pregnant and were suffering nausea and vomiting of pregnancy were randomised into 4 groups and received treatment weekly.
The acupuncture group, in which points were chosen according to a traditional acupuncture diagnosis, received two 20 minute acupuncture treatments in the first week followed by one weekly treatment for the next four weeks.
The sham acupuncture group were needled at points close to but not on acupuncture points and both the sham and Neiguan P-6 acupuncture groups were treated with the same frequency as the traditional acupuncture group.
All group received their treatment from the same acupuncturist.
The outcomes of treatment were measured in terms of nausea, dry retching, vomiting and health status.
When compared to the women who received no treatment, the traditional acupuncture group reported less nausea throughout the study and less dry retching from the second week. The Neiguan P-6 acupuncture group reported less nausea from the second week and less dry retching from the third week. The sham acupuncture group reported less nausea and dry retching from the third week.
So while all three acupuncture groups reported improvement with nausea and dry retching, it was the traditional acupuncture group that had the fastest response.
Patients receiving traditional acupuncture also reported improvement in five aspects of general health status (vitality, social function, physical function, mental health and emotional role function) compared to improvement in two aspects with both the Neiguan P-6 and sham acupuncture groups. In the no treatment group there was improvement in only one aspect.
Although there were no differences in vomiting found in any of the treatment groups the authors speculated that more frequent treatments might have produced greater benefits.
In assessing the safety of acupuncture in early pregnancy data was collected on perinatal outcome, congenital abnormalities, pregnancy complications and problems of the newborn.
No differences were found between study groups in the incidence of these outcomes suggesting that there are no serious adverse effects from the use of acupuncture treatment in early pregnancy.
Conclusion
Acupuncture is a safe and effective treatment for women who experience nausea and dry retching in early pregnancy.
Both my personal experience and research support the assertion that acupuncture is helpful for women suffering from nausea and vomiting in pregnancy. While there are no guarantees, acupuncture brings relief and improves the quality of life of most pregnant women that try it. It does not have side effects and is safe to use in pregnancy. Acpuncture offers new options to women.
Stay tuned for Morning Sickness III – self help suggestions and recommendations
December 24th, 2009
Why do they call it morning sickness when it lasts all day?
Nausea and vomiting in pregnancy (NVP) is an unwelcome, but perfectly normal, part of pregnancy that does not put your baby at any increased risk.
Although NVP is sometimes trivialized as a minor inconvenience of pregnancy, it can have a significant, adverse affect on your day-to-day activities and quality of life.
Morning sickness is a catchall term used to describe everything from a hypersensitivity to odors or an aversion to certain foods to severe vomiting. Between 60 to 80 percent of pregnant women experience nausea, retching, and/or vomiting, at some time during their pregnancy. The degree of nausea and vomiting you have during one pregnancy does not predict how you will feel in future pregnancies. Most pregnant women have nausea and vomiting during the early months of pregnancy often beginning in the first month of pregnancy and continuing until the 14th to 16th week (when 90% of cases are resolved). However, some women have nausea and vomiting through their entire pregnancy.
NVP is thought to be caused by the hormonal, metabolic and chemical changes of early pregnancy. It is more likely to be a problem for women who are carrying twins or other multiples or who are feeling run down. Emotional stress, traveling, or some foods may also aggravate the nausea.
About 1 out of every 300 pregnant women develops a severe form of morning sickness known as hyperemesis gravidarum (Latin for “excessive vomiting in pregnancy”). This condition occurs when the body is unable to compensate for the relentless vomiting and loses valuable body salts (electrolytes) and body fluids. The disorder is thought to be linked to higher-than-usual levels of the hormones hCG and estrogen, and it is more common in first pregnancies, young women and women carrying multiples.
If you are suffering from Nausea and Vomiting in Pregnancy, don’t despair! There are things you can do for relief.
In Chinese Medicine, acupuncture is the primary treatment for morning sickness in pregnancy. Acupuncture helps the body to balance itself and redirect energy flow, bringing relief from symptoms.
Energy can flow upward, downward, inward and outward. In digestion, the normal flow is downward. Food is eaten, digested and evacuated. But when a person is nauseated and/or vomiting, the usual downward flow has been reversed. This is called “counter flow of Stomach Energy (Qi)” in Chinese Medicine. There are a number of patterns that underlie counter flow. Distinguishing the exact pattern allows the acupuncturist to offer an effective treatment.
The Patterns for Morning Sickness
• Spleen and Stomach Energy (Qi) deficiency: Nausea and vomiting with epigastric fullness and bloating, no desire for food and drink, exhaustion and heaviness of limbs.
• Liver invading Spleen: Nausea and vomiting with a bitter or sour taste, depression or irritability, tendency to sigh and to be easily angered, chest heaviness.
• Stomach Fire: vomiting of food soon after it has been eaten, persistent thirst for cold drinks, heartburn, dizziness, constipation, red face, chapped lips.
• Phlegm: vomiting mucus or constant spitting of saliva.
It is possible to have a combination of patterns. An experienced practitioner can use acupuncture to help your body to balance itself. When the body returns to relative balance, symptoms disappear. With the constant changes of pregnancy, balancing becomes a lively, sophisticated dance.
