Eating During Pregnancy Sickness

First, a Word of Reassurance

If you are reading this page, you are probably struggling to eat. Perhaps the thought of food makes you feel ill. Perhaps you have tried everything and nothing stays down. Perhaps you feel guilty that you cannot eat the "healthy pregnancy diet" described in every book and app.

We want you to know: you are not failing your baby. In the first trimester, your baby is tiny — roughly the size of a raspberry by week 8 — and draws on your existing nutritional stores. Babies are remarkably efficient at taking what they need. Women who experience severe pregnancy sickness, including hyperemesis gravidarum, overwhelmingly go on to have healthy babies. Your body is designed for this, even when it does not feel like it.

The goal right now is not a perfect diet. The goal is survival — eating whatever you can, whenever you can, in whatever amounts you can manage. Perfection is not the standard. Getting through each day is.

Foods That Are Easier to Tolerate

Every woman's experience is different, and what works for one person may be intolerable for another. However, research and lived experience suggest that certain categories of food tend to be better tolerated during pregnancy sickness.

Bland Foods

Foods with minimal seasoning, mild flavours, and simple ingredients are often the easiest to manage. The less your food triggers your senses, the better the chance of keeping it down. Consider plain toast, crackers, rice cakes, plain pasta, mashed potato, porridge made with water, plain bagels, and digestive biscuits.

Cold Foods

Cold foods tend to have less aroma than hot foods, which is important when smell sensitivity is heightened. Many women find they can tolerate cold sandwiches, yoghurt, cold cereal with milk, fruit, ice lollies, cucumber, cold pasta salad, and cheese slices when hot meals are impossible.

Dry Foods

Dry, starchy foods can help absorb stomach acid and settle nausea. Keep plain crackers, dry toast, or rice cakes by your bed to eat before getting up in the morning. Eating something dry before you stand can reduce the wave of nausea that often hits first thing.

Salty Foods

Salty foods are often craved during pregnancy sickness, and there is a physiological reason — vomiting causes sodium loss, and your body may be trying to replace it. Salted crisps, pretzels, salted crackers, and marmite on toast are commonly tolerated. Do not worry about salt intake at this stage unless your GP has specifically advised you to restrict it.

Sour and Tart Foods

Some women find that sour or tart flavours help cut through nausea. Lemon water, lemon ice lollies, sour sweets, pickles, and citrus fruits can be surprisingly helpful. Sucking on a slice of lemon or sniffing a cut lemon can provide temporary relief from nausea.

Staying Hydrated

Hydration is more important than food during pregnancy sickness. Dehydration is the primary medical concern and the most common reason for hospital admission with pregnancy sickness. Even if you cannot eat, keeping fluids down is essential.

Strategies That Help

• Small, frequent sips: Do not try to drink a full glass at once. Tiny, frequent sips throughout the day are much more likely to stay down. Set a timer to remind yourself to sip every 10-15 minutes.
• Ice lollies: Frozen fruit juice lollies, frozen yoghurt lollies, or simply frozen diluted squash can be easier to tolerate than liquid drinks. The cold temperature helps reduce nausea, and the slow consumption prevents overwhelming your stomach.
• Ice chips: Sucking on ice chips delivers fluid slowly and can soothe nausea. Some women add a small amount of fruit juice to the water before freezing.
• Electrolyte drinks: Vomiting depletes essential electrolytes (sodium, potassium, magnesium). Oral rehydration solutions such as Dioralyte, available from pharmacies, can help replace what you lose. Sports drinks (diluted) can also help, though they contain more sugar.
• Temperature matters: Some women tolerate room-temperature water better than cold; others prefer ice-cold. Experiment to find what works for you.
• Separate food and drink: Many women find that drinking with meals worsens nausea. Try drinking between meals rather than during them, leaving about 30 minutes either side.

Essential Nutrients and Supplements

During pregnancy sickness, getting all your nutrients from food may be impossible. Supplements can help bridge the gap, but always discuss supplements with your GP or midwife.

Folic Acid

The NHS recommends 400 micrograms of folic acid daily until at least week 12 of pregnancy to reduce the risk of neural tube defects. If you cannot tolerate tablets, ask your pharmacist about liquid or chewable forms. Some women find taking folic acid at night, or with the one meal they can tolerate, helps. If you have been prescribed 5mg of folic acid (higher dose), it is especially important to find a way to take it.

Vitamin B6 (Pyridoxine)

Vitamin B6 has evidence supporting its use for pregnancy nausea. NICE guidelines and the Royal College of Obstetricians and Gynaecologists recognise it as a first-line option. The typical dose is 10-25mg three times daily. It is available over the counter but speak to your GP before starting it, as they may wish to prescribe it alongside other anti-sickness medication.

Iron

Iron supplements are notorious for worsening nausea and causing stomach upset. If you have been prescribed iron and cannot tolerate it, speak to your GP. Options include switching to a liquid form, taking it every other day (which research suggests may actually improve absorption), taking it with vitamin C, or using a gentler formulation. Do not simply stop taking prescribed iron without speaking to your healthcare team.

Vitamin D

The NHS recommends 10 micrograms of vitamin D daily throughout pregnancy and breastfeeding. If you cannot tolerate a tablet, spray or drop formulations are available from pharmacies.

Prenatal Multivitamins

If you cannot tolerate your prenatal vitamin, do not force it. Taking folic acid and vitamin D separately is more important than a comprehensive multivitamin. Some women tolerate gummy vitamins better than tablets. Others find that taking their vitamin at night, with food, or splitting the dose helps. Speak to your pharmacist about alternative formulations.

Foods to Avoid

The standard NHS advice on foods to avoid during pregnancy still applies, even when your diet is restricted. Key foods to avoid include:

• Raw or undercooked meat, poultry, and eggs
• Unpasteurised dairy products and soft mould-ripened cheeses (brie, camembert)
• Pate (including vegetable pate)
• Raw shellfish
• Shark, swordfish, and marlin (due to mercury)
• More than 200mg of caffeine daily (roughly 2 cups of instant coffee)
• Alcohol

If your diet is very restricted due to sickness, do not add stress by worrying about "superfoods" or an ideal pregnancy diet. Focus on what you can tolerate and discuss any concerns with your midwife.

Meal Ideas by Severity

Severity	Breakfast Ideas	Lunch Ideas	Dinner Ideas	Snacks
Mild (nauseous but can eat)	Toast with butter, porridge, cereal with cold milk, banana	Plain sandwich (cheese, ham), jacket potato, soup with bread	Plain pasta with butter or mild sauce, rice with chicken, fish fingers and chips	Crackers, fruit, yoghurt, rice cakes, plain biscuits
Moderate (frequent nausea, some vomiting)	Dry toast, crackers in bed before rising, small bowl of cereal	Cold sandwich, cheese and crackers, cold pasta	Mashed potato, plain rice, toast, small portions only	Ice lollies, crisps, dry cereal by the handful, ginger biscuits
Severe (constant nausea, frequent vomiting)	A single cracker or bite of dry toast, sips of flat lemonade	Whatever you can manage — even a few bites count	Tiny portions of anything tolerable — ice lollies if nothing else	Ice chips, ice lollies, sips of electrolyte drinks, whatever you can keep down

What Your Baby Needs vs What You Can Manage

One of the most common fears during pregnancy sickness is that your baby is being harmed by your inability to eat well. Research is reassuring on this point:

• In the first trimester, your baby's caloric needs are minimal — only about 100 extra calories per day, equivalent to a banana and a glass of milk
• Your body has nutritional reserves that your baby can draw on, even when your dietary intake is poor
• Studies of women with hyperemesis gravidarum show that birth weight is generally not affected unless the mother loses more than 5% of her pre-pregnancy weight and the weight loss is sustained
• Babies born to women with severe pregnancy sickness are overwhelmingly healthy
• The second and third trimesters — when caloric needs increase more significantly — are typically when sickness improves, allowing you to eat more normally

This does not mean your suffering does not matter. It absolutely does. But it does mean you can let go of the guilt about not eating "properly." Your baby is resilient, and you are doing enough.

When to Get Nutritional Support

Sometimes pregnancy sickness is so severe that you need professional nutritional support. Do not hesitate to ask for help if:

• You have lost more than 5% of your pre-pregnancy body weight
• You have been unable to eat any food for more than 48 hours
• You are unable to keep fluids down
• You feel dizzy, faint, or have a rapid heartbeat
• You are worried about your nutrition — worry itself is a valid reason to seek help

IV Fluids

Intravenous (IV) fluids are used to treat dehydration caused by severe pregnancy sickness. They can be administered in hospital or, in some areas, through ambulatory day units or even at home. IV fluids typically contain saline (salt water) with added glucose and electrolytes. Many women report feeling significantly better after IV rehydration. If you need IV fluids, this is not a failure — it is appropriate medical treatment for a medical condition.

Nutritional Support for Severe HG

In the most severe cases of hyperemesis gravidarum, additional nutritional support may be needed:

• Nasogastric (NG) tube feeding: A thin tube is passed through the nose into the stomach to deliver liquid nutrition. This bypasses the need to eat and can provide complete nutritional support.
• Total parenteral nutrition (TPN): Nutrition delivered directly into a vein, bypassing the digestive system entirely. This is reserved for the most severe cases where other approaches have failed.
• PICC lines: Peripherally inserted central catheters can be used for longer-term IV fluid and nutrition delivery at home.

These interventions are uncommon but can be life-saving for women with the most severe HG. If you think you might need this level of support, speak to your medical team. You deserve adequate nutrition, and there are ways to achieve it even when eating is impossible.