Q: My wife has completed 4 months of pregnancy and recently she went for health check and found she has lost around 3 kg. Weight between her last checkup two months back. Even though she has completed 4 months she had a lot of vomitting and despite having doxinate according to doctors prescription there is no improvement. This is her second pregnancy; in her first pregnancy she never had vomitting problem.

A:Losing 3 kilos in the first half of the pregnancy is not alarming. Most women lose one to three kg in between second and the fifth month there are various reasons for it but for now it may suffice to say that it is normal and you should not worry about it. The nausea should have settled by now or maybe it will now, in the next few weeks. The causes of Nausea during pregnancy are not fully understood. Therefore it cannot be cured. The best one can achieve is to make you as comfortable as possible. There are a few things which you should keep in mind. 1. The nausea of pregnancy is a trigger and will only get worse once it starts in the morning. 2. The triggers of nausea are many and vary from person to person. You will have to identify the things, smells, taste, even the thoughts which cause nausea. It could be something you eat drink or a perfume and it is not necessarily an allergy, meaning thereby that something you have loved all your life, you may start hating - like some perfume or a particular food. 3. The commonest nausea inducing agent in early morning is toothpaste. So you do have to brush your teeth last thing in the night but not necessarily the first thing in the morning (something we all do but may not be essential). 4. Empty stomach, especially in the morning, triggers nausea. As soon as you get up you must take a small bite. Take a small biscuit before you get up (in the bed) and maybe a cup of tea or coffee. If you cannot eat anything before you brush your teeth then just rinse your mouth with plain water. If that does not satisfy you, you may even brush your teeth but without toothpaste, and then take a small snack like a biscuit. 5. Cooking smells are another potent cause of nausea, so are petrol fumes and extremes of temperature long journeys would also be uncomfortable. Basically you have to identify the agents which trigger nausea in you and have to avoid that agent, even if you have to be rude like asking someone not to smoke in your presence. The drugs given (like Doxinate) can be helpful but will never fully cure nausea, if it has not helped so far it is unlikely that it will help now (I hope you are taking the drug properly and at the right time. Please check with your doctor that you are taking the right dose) It is interesting that you say that the nausea was not there in the last pregnancy. This can happen. The second pregnancies are more symptomatic meaning thereby that it causes more symptoms (like backache, nausea, weakness) though it has fewer complications (like hypertension and low birthweight) than the first pregnancy. This is contrary to the normal perception, again there are a lot of theories about it, as I said we do not know why nausea occurs so we cannot really explain why it is more in the second pregnancy but we assume it is because of some kind of an allergic response to the fathers proteins (half of the babies proteins are genetically fathers). For all allergies, prior exposure to the protein is required. This partly explains why you have more pregnancy symptoms in the second pregnancy as compared to the first. While she is having nausea she has to be careful about her eating habits during this part of the pregnancy. Diet in early pregnancy: You do not have to worry too much about nutrition at this stage of the pregnancy. In other words there are no good or bad foods of pregnancy. There should be no force feeding and no restrictions. Food which does not bring on nausea is good food for you and vice versa. However nutritious a food may be, like milk of green vegetables, if it causes nausea in you, please do not take it. As long as the food is not infected (bought from outside) it is ok, however un-nutritious it may be. You do not have to eat too much. Whatever you are able to eat is good enough. Anything more if you force yourself will only cause vomiting. If you cannot eat anything at all even then it is ok as long as you do not get dehydrated so you must have a lot of fluids. 1. You must take a meal every hour or two throughout a day. 2. Breakfast an hour or more after getting up and /then an early pre-lunch snack at around 11 am. 3. Lunch followed by a late afternoon snack and then an evening tea followed by an early dinner. 4. All meals of the day should be small. 5. Do not eat too much and also do not starve. You must take frequent small meals. Eating too much at one go will cause vomiting and remaining hungry would lead to nausea. I hope this adequately answers your doubts.