NVP Counselor
Date: 2004-07-23

Question:
I am the mother of two and with both I was so sick the first trimester that I couldnt get out of bed. I spent my days sleeping and vomitting. With my first I was hospitalized twice for dehydration. I lose approximately 20-30 lbs. from lack of eating! I am in school and want to get pregnant before my two children are to old, but I am so scarred that I will be sick like before and will be dropped from my classes for lack of attendance. I am in desperate need of a solution to my SEVERE sickness that I experience during the first trimester of preganacy. Please help. P.S. My doctor prescribed me Zofran during the 2nd and 3rd trimester with my last child. I seemed to help, but I need something for the first trimester when things are extremely bad!!

Answer:
First of all, NVP symptoms during another pregnancy may not necessarily be as severe. However, starting treatment at the very first sign of symptoms is important. In Canada, we use Diclectin (Vitamin B6 and doxylamine succinate) from the onset of the NVP, (i.e., in the first trimester), and up to 9 months if needed. In other countries where Diclectin is not available, Vitamin B6 (25 mg, 3 times per day) can be started even prior to pregnancy and doxylamine succinate (12.5 mg, 3 times per day) can be added at the very first hin of nausea. this treatment has been safely used for over 40 years.

Other treatment options (including treatment with Zofran in the first trimester) are listed in our treatment algorithm. You may wish to discuss it with your doctor.

Sometimes, women with severe symptoms can also be H Pylori positive and require entirely different treatment. Again, talk to your doctor. Questions about the risk or safety of medications can be discussed with a Motherisk counselor by dialing (416) 813-6780, or with a teratogen information specialist in your area. To find one, visit the OTIS website.

So stay positive, do not expect the worst but be ready for it by talking to your doctor and starting treatment immediately upon the onset of symptoms.