Dear Kate: Here’s 9 things I learnt about hyperemesis gravidarum (the hard way)

Duchess Kate Middleton

Dear Kate,

Your secret is out and the world now knows that a new royal baby is on the way – congratulations on your pregnancy! To be honest, I’m not surprised you’ve had to come clean so early on, given the reports already circulating that you’re suffering once again with the dreaded and misunderstood pregnancy sickness – hyperemesis gravidarum. Ugh, it is the worst, isn’t it?

It is sooo much more than the usual ‘morning sickness‘ that many women experience in the earlier days of their pregnancy. Unfortunately for us HG sufferers, there is rarely an end in sight until our baby is in our arms. And it’s especially difficult to cope when you also have older children to care for.

I know you’ve been through it all before, but just in case the constant nausea, frequent vomiting, complete lack of energy and overall crappiness that is hyperemesis gravidarum has given you an early case of baby brain, here are a few tips I learned from my double trip through the trenches – especially how to cope with the kids you already have when you’re feeling so awful.

Surviving hyperemesis gravidarum when you have older kids to consider

1. Stay hydrated 

Dehydration is a key factor with HG, and it can set in quickly when you struggle to keep any food or drinks down. Dehydration is not only dangerous for mum and baby, but it can cause symptoms like dry mouth, dizziness, headaches and muscle cramps. These symptoms not only add to how terrible you’re already feeling and sap your energy for dealing with your other children, it may even lead to you needing to be rehydrated in hospital. So even though it’s hard to keep anything down, it’s super important to keep hydrated. My tips for keeping some fluids down are:

  • Drink tiny sips of water or fluids as often as you can stomach it – aim for a few small sips every 5 minutes.
  • Avoid gulping or taking large mouthfuls – your tummy will handle small sips better.
  • Keep some electrolyte ice blocks in the freezer to replace the electrolytes you lose when you vomit.
  • Try sucking on ice or ice blocks.
  • Keep a drink bottle of water on hand – even if you leave it out of reach, your toddler can fetch it for you (and you don’t have to worry about spills).

2. Eat like your toddler

The LAST thing you want to think about when you feel like death warmed up is food! But trust me, keeping your food intake up is important for both your energy and bub’s health. A trick I learned was to eat with my toddler – who basically didn’t stop eating all day. My little one was a grazer, so I supplied regular healthy but small snacks to keep her going through the day. These little snacks proved perfect for me – as eating too much at once was sure to have me heaving. Eating like my toddler meant I nibbled on something small but nutritious as often as I could. Perhaps George could help fix you something simple to eat from time to time? Fruit, toast or breakfast cereal are all easy for kids to make and he’ll feel great about helping mum when she’s unwell.

3. Be clear with your partner and family about what you need

Yes, you can dispense orders like the Queen of England right now (even if you are only a lowly Duchess). Whenever you can stay put and ask someone else to do it – my advice is STAY PUT! Delegate everything you can to friends and family. They will survive! And let’s face it, it’s GOOD for them to help you out around the palace a bit more, amiright?

4. Teach your kids to help

Further to point 3, if your kids are old enough to walk (which they are!), they can be a big help, so put those kids to work, mama! Little kids can help with things like grabbing your drink bottle or a nappy when they need a change. They can pick up toys and put them away (even if it is one at a time and takes two hours). They can choose their own clothes for the day – who cares if they’re wearing nothing but swimmers and a Batman mask? Just whack some pants on before you leave the house, and you’re set. Older kids can help with preparing dinner, feeding pets, and all sorts of odd useful jobs around the house. Not only will they be helping you out, they’ll be learning a lot about responsibility, compassion and everything Mum usually gets done on a daily basis without their help!

5. Accept any and all help

If a friend offers to stop by the palace to cook your family a meal, or drop George to school, don’t feel too proud to accept, even if you’re feeling OK that day. With HG, you just never know when you’ll need to curl up into a ball for a while, and having some little things taken care of can be a huge blessing. Grandparents, aunties, uncles and friends are a great source of help when you’re struggling. They wouldn’t offer if they didn’t want to help, and you know you’ll return the favour one day.

6. Consider daycare or a babysitter/nanny

My two year old daughter was already attending daycare one day a week so that I could work part time, so when the HG hit early in my second pregnancy, this was a lifeline! As my pregnancy went on and the HG got worse, we opted to send her two days a week, simply to give me some time to rest and to make sure she got plenty of stimulation when I was unable to give her much of it myself. I urge any mother to consider a regular babysitter, nanny or daycare during this difficult time. Not only does it give you a break, but your little one will benefit from a regular outing from the house and the social interactions and activities they’ll encounter. Plus, they’re usually so tired afterwards, you get a fairly quiet evening as well once they crash out. Bonus!

7. Pamper yourself

When you’ve been feeling so ill for so long, sometimes a little bit of pampering can brighten you up just that little bit, making it easier to cope with day-to-day life. A soothing organic facial, massage, or a long soak in the bath can be as good for the soul as it is for your skin and body. (Hey William, you hear that? Time to break out the foot rubs!) You deserve it – after all, you ARE growing a human here!

8. Ditch the guilt

It sounds easier said than done, I know. When you feel so ill you can barely get off the couch, and every movement or bite to eat sends you dashing for a v-bag, mustering up the energy to cook a nutritious meal or take your kids to the park can seem like an insurmountable task. It’s easy for the guilt to set in when we feel like we’re not being the best mum we can be, and I’m here to tell you to stop that right now! If you get more takeaway meals than usual, have a sinkful of dishes, and haven’t played with your kids in the backyard for a few days, give yourself permission to go easy on yourself. You really are going through one of the hardest times of your life right now, and it’s OK to focus on you and your needs. Your kids will be fine – it’s not forever and you’ll be back to the games soon enough.

9. Remind yourself it’s not forever

I know it sounds terribly glib, but it did help me to remind myself of this small fact now and then. When every day is a struggle, it is really disheartening and overwhelming, and it can send some women into an emotional spiral at a time when they should be feeling the happiest they’ve ever been. The one thing that helped me during the darker times was reminding myself that it would all be over as soon as I had my baby in my arms. There is a (very cute and noisy) light at the end of the tunnel!

It’s not easy, mama. Even with all the tips in the world, hyperemesis gravidarum was one of the hardest things I have ever had to endure. These are just some of the things that helped me the most, and I hope they help you too.

Suze x

What is hyperemesis gravidarum?

Hyperemesis gravidarum (HG) is a pregnancy condition that causes severa nausea and vomiting, weight loss and an imbalance of the body’s electrolytes.

While 70-80 percent of women experience some type of morning sickness during pregnancy, a diagnosis of HG is unusual, with an estimated 0.3-1.5 percent of pregnant women suffering from the condition.

Mild cases of hyperemesis gravidarum can usually be managed with rest, changes to the diet and antacids. More severe cases though, often require hospitalization to manage dehydration. 

What causes HG?

HG is believed to be caused by the rise in hormone levels associated with pregnancy, with symptoms usually appearing early in pregnancy – around 4-6 weeks – and peaking around 9-13 weeks. While most women find the symptoms ease after 20 weeks, some unlucky women suffer from hyperemesis gravidarum right up until they give birth.

What’s the difference between morning sickness and HG?

The main markers for a hyperemesis gravidarum diagnosis are:

  • Nausea accompanied by severe vomiting
  • Constant nausea that doesn’t subside
  • Dehydration caused by severe vomiting
  • Vomiting that prevents you from keeping any food down
  • Weight loss of 5 percent or more of your pre-pregnancy weight

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