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Although there are other factors involved as known causes for morning sickness, one of the main causes of morning sickness is low blood sugar (also called hypoglycemia). Examples of other causes besides hypoglycemia are fluctuating hormone levels, and some people believe that morning sickness is a built-in method from nature to protect the early fetal development from injuring-microbes that might be consumed in foods, such as meats, that are commonly associated with food-borne illness.)

When you are very early in the pregnancy, your body has not yet adjusted to "eating for two" and may not be regulating your blood sugars as well as usual. While you are sleeping, and not consuming any foods, the fetus is still "eating" your stored calories. This makes your blood sugar dip low by morning, which typically causes nausea (even when not in pregnancy).

Proteins are metabolized slower in the body than are carbohydrates, meaning that the calories last longer when you eat proteins and keep your blood sugars more stable when fasting at night. That is why if you eat a protein snack at night (cheese, meat, peanut butter, etc.), it can help your blood sugar stay more stabilized until breakfast.

Often, if you will eat the very first thing upon waking up one or two plain soda crackers (aka saltines), it will help prevent morning sickness because they are a rapidly absorbed source of carbohydrates that can more quickly increase the blood sugar levels to replenish. Once that has relieved any nausea from the low blood sugar, you then eat a nutritious breakfast (that includes proteins to steady the blood sugars) to help you start the day with fewer morning sickness symptoms.

Not all women experience morning sickness, which is another sign that it is likely associated with how a woman's body metabolizes calories and stabilizes blood sugar levels. That is why, in some women whose bodies do that less well than others (even when not pregnant), "morning sickness" can happen any time of the day and not just in the morning. It also can happen either only at the beginning of pregnancy or continue longer, even up until delivery in some unfortunate women.

The best all around plan for avoiding morning sickness symptoms (or nausea due to hypoglycemia at any time of the day), is to eat small portions but more frequently. These frequent mini-meals should include all types of foods, i.e, proteins, complex carbohydrates (like fruits and vegetables), fats, whole grains, etc., and avoid as much as possible the simple carbohydrates (like saltines, most breads that are not whole grain, sweets, and other "starches" like corn, white rice and white potatoes). Five or more smaller meals is much better than only three big ones. Some women switch to eating every two or three hours all day with protein at night to keep the blood sugars even.

Ask your obstetrician to suggest the most appropriate diet for you while your baby develops.

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Q: Why does eating a protein meal late at night prevent morning sickness?
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Not the classic hormone caused one, it occurs too soon in pregnancy for the twins to mass enough to count. However, often morning sickness is caused by low blood sugar. It often happens in the mornings because you are not eating during the night, but the baby continues to use your stored calories. This can make your blood sugar levels dip by morning. Low blood sugars can make you feel nauseated, shaky, and sweaty and even vomit. When you have twins or other multiple fetus pregnancies, the blood sugars can dip even more during fasting at night and you may feel more sickness from that in the morning before you take in some calories to raise your blood sugar back up. See the related question below, "Why does eating a protein meal late at night prevent morning sickness?", for more information about this cause of morning sickness in many women.


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