My wife is in her first trimester of pregnancy and is sick everyday. I believe what she's eating and how much she's eating are factors in her nausea. Any nutrition tips that might ease her sickness are greatly appreciated.

-- GD

So-called "morning sickness," (a misnomer because nausea can occur any time of the day or night), is very common in early pregnancy. It often starts shortly after the first missed period and continues until about 16 weeks. Most of the time, it is mild to moderate in intensity, but sometimes it is so severe that it requires intravenous fluids and/or hospitalization. When morning sickness gets this bad we call it "hyperemesis gravidarum."

Certain foods and smells may trigger that queasy feeling and should be avoided. What those triggers are varies from woman to woman. Often, eating frequent, small high carbohydrate meals can help settle the stomach. I recommend keeping crackers or pretzels at the bedside and munching on a few before getting up. Then, eat a little bit of food every 2 hours throughout the day. Avoid heavily spiced or greasy foods, as they tend to exacerbate the nausea. Some women get sick from their prenatal vitamin, and I'll sometimes prescribe a different brand. If that doesn't help, it's okay to stop taking the vitamins until the nausea abates.

Ginger is also good for calming an upset stomach; either ginger tea or gingerroot capsules will work. But do not use more than 10 capsules per day, and do not use ginger if there is a history of miscarriage. Peppermint or spearmint teas are other options if your wife doesn't like the ginger tea. Vitamin B6, 25 mg 2-3 times per day, has been shown to be effective in studies, as has the use of acupressure. Acupressure wristbands for seasickness (SeaBands) are available in many pharmacies as well as in boating supply stores. If these measures are not effective, prescription anti-nausea medication may be necessary.

If your wife is throwing up so much that she is getting weak, cannot even keep down liquids, or is vomiting blood, then she must see her doctor immediately.