Kate Middleton is expecting her third child—and is once again suffering from the pregnancy-induced condition known as hyperemesis gravidarum. Here's an expert's take on handling morning sickness, no matter how mild or severe.

Kate Rope
September 05, 2017

Kate Middleton and Prince William are expecting their third child, People reported yesterday. And while Prince William said this weekend that the pregnancy was "very good news," Kensington Palace confirmed that the Duchess of Cambridge is once again suffering from hyperemesis gravidarum—the severe form of morning sickness she also experienced throughout her first two pregnancies. 

While Middleton was hospitalized during her first pregnancy with Prince George, a statement from Kensington Palace reported that she is being cared for at her home this time around. (She was also treated at home during her second pregnancy with Princess Charlotte.) As with the Duchess's previous pregnancies, the Palace seems to have announced the family's good news earlier than the traditional three-month mark, as Middleton's symptoms have required her to cancel planned events. 

Hyperemesis gravidarum, a rare but debilitating condition, has been described as “the morning sickness from hell.” But this persistent nausea and vomiting doesn't just occur in the morning, and unlike run-of-the-mill morning sickness, it often lasts throughout an entire pregnancy.  Only 1% to 2% of pregnant women suffer from hyperemesis gravidarum, which can lead to dangerous weight loss, severe dehydration, and kidney and liver damage. Although the condition is treatable, it can become life-threatening and can even require pregnancy termination.

Back in 2012—when Middleton was pregnant with her first royal baby—Health spoke with Chad Klauser, MD, assistant clinical professor of obstetrics and gynecology at Mt. Sinai School of Medicine. He pointed out then that while cases of hyperemesis gravidarum are few and far between, it’s rare that any woman escapes pregnancy without some brush with nausea.

“Morning sickness affects about 80% of women in the first trimester,” Dr. Klauser told Health. Here are his tips for treating routine morning sickness—and how to know whether it's something more dangerous that requires more serious medical care. 

  • Find your food triggers. Carbohydrates are often easier to tolerate than other foods. “Cheerios and toast are good first line foods to try," he says.
  • Avoid warm foods. These can worsen nausea. Instead opt for cold picks or hot beverages, such as tea.
  • Stay away from fatty foods.
  • Eat small, frequent meals throughout the day.
  • Keep hydrated. Try Popsicles, Pedialyte, or any fluids you can get down.
  • Try an over-the-counter treatment. These include vitamin B6 and Unisom, which can also be helpful, says Dr. Klauser. “Both have a long history of safety in pregnancy and improve morning sickness in approximately 80% of cases.” If those don’t work, there are prescription medications that are used safely in pregnancy to alleviate nausea.

Any woman who notices she is losing weight in pregnancy or is unable to tolerate foods or fluids for more than 24 hours should contact her doctor, says Dr. Klauser. Left untreated, hyperemesis not only leads to dangerous dehydration, but can also result in social isolation and depression. In cases like Middleton's first pregnancy, it can require hospitalization and treatment with IV fluids and medications. A 2012 review article in the journal Reviews in Obstetrics and Gynecology found that in addition to medications, stress relief and alternative treatments such as acupuncture and hypnosis were effective in relieving the nausea and vomiting associated with the condition.

Beyond the happy news that she’s expecting, Kate’s condition could actually be a sign that her third baby, like her first two, is healthy. “Hyperemesis is thought to be somewhat protective,” Dr. Klauser said. “There’s a statistically decreased risk of fetal malformations in people who have severe vomiting or hyperemesis in pregnancy.”

Hopefully with the proper treatment, Duchess Kate feels better soon, so she and Prince William (and siblings George and Charlotte) can get back to celebrating their growing royal family.

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