Your support is crucial to her coping and recovery
This guide provides practical ideas for helping a woman with hyperemesis gravidarum.
Diet - cravings: pregnant women with hyperemesis gravidarum (HG) as well as their families and friends need to be understanding and adaptable, especially in regards to diet. Food cravings can be bizarre, complex and irregular; often a woman's whole life becomes centered on finding palatable food. Cravings often appear for only a short time - sometimes just a few minutes, and need to be fulfilled if at all possible. She can’t help these preferences and needs a compassionate response to her food requests.
The primary goal is to increase nutrient and fluid intake whatever she can eat and keep down is her best diet.
If she can only eat ice cream, find the healthiest version she can tolerate and encourage her to eat as much as she can in small portions. This means preferably organic or brands with natural ingredients (no synthetic colors, flavors, and additives), perhaps with fruit so she gets some extra nutrition.
Support: it's important to create a network of support for all aspects of daily life to minimize stress and provide foods as tolerated. Stress (mental, physical or emotional) and malnutrition only worsen HG.
Top 10 ways you can help
a women with HG
Mothers with HG often are unable to tolerate the following:
- Blinking/bright lights (e.g. sunlight)
- Sight/thought/smell food (e.g. TV, others eating, grocery)
- Noise (e.g. TV, kids)
- Feeling/seeing motion
- Food smells (e.g. garlic, fermented foods, yeast, fish)
- Standing or sitting upright
- Empty stomach
- Any smells (scented toiletries, cleaners, exhaust, diapers, etc.)
Understand she may need to sleep alone as her sense of smell is heightened and she can likely smell food on your skin and breath. Don't be offended by this. It is a hormonal reaction. She also may be unable to tolerate the extra motion, and may even be unable to shower daily.
- Pressure on her stomach (e.g. tight waistband)
- Stimulation of gag reflex (e.g. swallowing pills)
- Riding in the car (See Homeopathic Remedies.)
- Vitamins & herbs (esp. with iron)
- Lack of understanding & support from others
- Inability to take vitamins or eat healthy
- Taking medications perceived as risky
- Difficulty advocating for herself and her child
- Missing out on the "fun" of being pregnant
- Loss of a "normal" pregnancy
- Lost work days or quitting work/school
- Putting life "on hold" for many months
- Longing to eat and drink normally
- Money expended on care and support
- Lack of energy and severe fatigue
- Irritability and lack of enjoyment in life
- Memory loss or inability to problem solve
- Burden of care and time on others
- Lack of socialization (i.e. isolation)
- Inability to prepare for birth/arrival of baby
- Inability to care for family and home
- Wanting to terminate the pregnancy to end the misery
- Other's misperception that HG is only in her mind
- Loss of hope that symptoms will cease before birth
- Fear of painful treatments or being force fed
- Reluctance of doctors to treat due to cost or liability
- Weight loss or inadequate gain for gestational age of baby
- Fluctuating emotions due to hormones and illness
- Sense of inadequacy/failure at being unable to cope or function
- Fear of harming baby or more difficult birth
- Fear of morbidity, permanent illness, or death
- Difficulty bonding with baby
- Lack of energy and socialization for kids
- Lack of excitement about baby's arrival
- Dreading the prolonged recovery time
- Allow her to do whatever is necessary to cope, including quitting her job without complaint or guilt. Read about the impact of HG.
- If possible, avoid major decisions and stressors such as moving until she has fully recovered from HG and birth.
- Don’t pressure her to “get well sooner” or start taking on responsibilities right after delivery. It takes time to rebuild muscle and energy stores.
- Women don't often ask for help when needed. Ask that they arrange a time that works for her, but not ask if she needs help. Assume she does, she just doesn't want to burden others. Ensure others know it’s imperative they avoid wearing scented products and using chemical cleaners when they visit.
- If you have limited support and can afford to hire help, consider a doula. "Doula" refers to a supportive companion (other than a friend or loved one) who is professionally trained to provide labor support ("birth doulas"); or experienced in providing postpartum care ("postpartum doulas") such as mother and newborn care, breastfeeding support and advice, cooking, child care, errands, and light cleaning for the family.
Cards and small gifts are encouraging except scented items like candles, flowers, etc. Always remind them to eliminate all smells and not be offended if she is unable to shower or interact much during their visit.
- She will likely have difficulty being assertive or thinking clearly due to metabolic imbalances. If either of you feel her treatments are ineffective or inadequate, be assertive in seeking other options and/or doctors.
- Before she goes in for a GTT (glucose tolerance test), discuss with her health professional the use of apple juice or jelly beans instead of Glucola. The results will often be more accurate since women with HG often cannot tolerate Glucola.
- Consider buying Ketostix at a drug store or pharmacy - sticks to dip in urine to test for ketones, an indication of starvation and the need for IV hydration.
(Offsite Resources: What is Ketosis?)
Nutritious liquid meals are a good choice as they are easier to digest. From protein powders to fresh fruit or vegetable juice, these drinks can be packed with nutrients.
- Continue this postpartum as it can take several months to recover, especially if HG continues into late pregnancy.
- Remember this is a short period in life and it's critical to help as much as you can.
- Remember: Avoid cleaning products and anything with strong odors.
- Accept offers for help, as well as food preparation unless the smells bother her. (Hint: Cold foods often have less smell.)
- Make others aware of her food aversions and eat aversive foods away from her as needed. Grill food outdoors or use fans to redirect smells away from her.
- She will need to mourn the losses like missing the joy of pregnancy, and find the path to healing emotionally as well as physically.
- Seek medical care if she is anxious or severely depressed (i.e. her depression is interfering with her ability to care for herself and her family). See Postpartum Recovery for more info.
- Avoid making her feel weak for struggling physically or emotionally! Many pregnant women have significant difficulty coping with the stress and change of pregnancy and motherhood. Adding HG makes it even more difficult!
- Remember, she was sick for 6-9 months, it may take that long and maybe more to recover fully.