Is it morning sickness or Hyperemesis Gravidarum?

What are the symptoms of Hyperemesis Gravidarum?

The first signs you may be suffering from more than usual morning sickness are:

• You vomit more than four times a day
• You begin to lose noticeable amounts of weight
• Your vomit contains blood or looks like coffee
• You lose more liquid than you can keep down

If you have any of these symptoms, then talk to your midwife or GP.

However, if you experience any of these more serious signs, you should seek urgent medical help:

• Have very dark wee or don't wee for more than eight hours
• Have abdominal pain
• Have a high temperature - we're talking of 38 degrees C (100.4F) or above
• Feel really weak, dizzy or faint when standing up
• Vomit blood
• Have a racing heart rate
• Have repeated episodes of vomiting
• Can't keep food or fluids down for 24 hours

Sometimes, what you think is morning sickness - the nausea and the vomiting - could be a sign of a different problem, such as a urinary tract infection, appendicitis or pancreatitis - so make sure you get medical advice.

So what is Hyperemesis Gravidarum?

Everyone was talking about Hyperemesis Gravidarum in 2013 when Kate Middleton was diagnosed with it during her pregnancy with Prince George. It affects one in every 1,000 pregnant women, so it's not a common condition.

Hyperemesis Gravidarum can vary greatly in degree and duration, but the relentless vomiting and nausea can lead to a weight loss of over 5% of your body weight.

It can also mean frequent vomiting even up until birth. In extreme cases, you may even need to throw up after swallowing your own saliva. Ouch.

How is it treated?

Treatment usually involves special drugs to suppress vomiting, anti-emetics, and possibly a hospital stay and feeding and rehydration through an intravenous drip - to avoid dehydration of malnutrition.

Some doctors may misdiagnose a case of Hyperemesis Gravidarum as severe morning sickness, as it's not an easy condition to diagnose. It's important to let your doctor know exactly how often you are sick and how much weight you have lost, and that you suspect you are suffering from Hyperemesis Gravidarum.

How it may affect you

With morning sickness you may be unable to cook hot meals or need a short time off work. With Hyperemesis Gravidarum, you could be bed-ridden for weeks, unable to work for long periods, too ill to cope with domestic tasks and need far more support from your family and friends.

For your partner it can be stressful because he has to take on most of the domestic duties and responsibilities. He may find it very distressing to see you go through so much and feel frustrated if he feels he can do nothing to help.

How to cope with Hyperemesis Gravidarum

Seeking medical treatment is the most important thing you can do.

But there are also a few things that you can do that may help...

• Massage - this can help relieve symptoms of nausea and is an easy way for your partner to offer you relief.
• Rest - trying to do too much will only increase your stress levels and make your sickness worse
• Separate food and drinks - you'll have more chance of keeping food down if you keep the hour around eating fluid-free. You'll need to make up the fluid intake between the times you eat though
• Vitamin B6 - some GPs may recommend taking vitamin B6, although this isn't backed up by strong scientific data. In 2010, researchers stated that there was limited evidence of its effectiveness
• Ginger - ginger products including tea, biscuits and non-alcoholic ginger ale might help ease some of your symptoms
• Herbal teas - peppermint, ginger and fennel may settle your stomach and help digestion
• Dry and plain foods - startthe day with a couple of crackers or a bit of toast, even before you get out of bed
• Eat small amounts of food, more often - If you can't eat solids, try milkshakes or smoothies
• Sweets - sucking on a boiled sweet may help if you're suffering from excessive saliva sweet.

So will I get it for each of my pregnancies?

If you've suffered Hyperemesis Gravidarum once, it doesn't automatically mean you'll get it again. However, we have to be honest, the chances are quite high, although it may be a different experience.

Whatever happens, it makes sense to assume that you could suffer from it again so you can prepare yourself mentally and physically for the possibility.

If you have suffered Hyperemesis Gravidarum, it's important you give your body plenty of time to recover before you get pregnant again.

Mum’s story

“I had Hyperemesis Gravidarum with both pregnancies”

“I had Hyperemesis Gravidarum during my first pregnancy, so I knew the signs, and this time it started at around 8 weeks. I had sickness from waking up and all through the day. On the worst days it was every half an hour, sometimes going on throughout the whole night as well. I was regularly admitted to the clinic throughout this pregnancy and stayed for a few days at a time, where I had a drip to rehydrate me.

“It’s important to be assertive about getting help – the longer you leave it, the worse it gets. I was constantly told it was normal and it would pass at 12 weeks. Also, eat whatever you want, because your baby will be fine. If it stays down it’s good. Drink water all the time too, because hydration is the key to the whole thing.”

Jules, 30, mum to Winnie, 5, and 34 weeks pregnant