A pregnant woman is typically more cautious than usual about what she puts into her body, and rightfully so. Her food, drink and supplements choices can directly affect her baby's health. But what about how mom feels? At times pregnancy can be fraught with physical distresses. There's no need for moms-to-be to just endure those discomforts. Simple natural treatments can ease nausea, heartburn, indigestion and constipation. There are also safe options for boosting energy and alleviating cold symptoms. Next time you're discussing prenatal vitamins with a customer, remind her about these available choices in case she needs them during her pregnancy.

Safety First
Caution is paramount with every medication or supplement taken during pregnancy. "Most substances moms take can pass through the placenta to the baby. Mothers want to be careful because not everything that is appropriate for an adult is appropriate for a developing fetus," says Aviva Romm, a midwife and herbalist practicing near Atlanta. "Some substances have unknown effects and some may have harmful effects, so it is always good to be cautious, especially since there is so little known." Urge your pregnant customers to discuss any supplement with their health care providers before they use it. That said, there are safe herbs and supplements to make those pregnant months a little easier.

Nausea
Ginger is the obvious choice when it comes to morning sickness, which, despite the name, can occur any time of day. "Ginger root is the single remedy that has been studied the most and shown to be effective and safe during pregnancy," says Romm, who is also president of the American Herbalist Guild and author of The Natural Pregnancy Book (Celestial Arts, 2003). She advises her clients to take up to 1 gram a day of dried powder in capsules or to sip fresh gingerroot tea throughout the day.

Depending on the symptom profile, homeopathic remedies also can soothe stomachs. "Ipecacuanha [ipecac] is used in all types of nausea, whether a person is pregnant or not," says Dana Ullman, MPH, of Berkeley, Calif.-based Homeopathic Education Services and author of several books on homeopathy, including the e-book Homeopathic Family Medicine. "It is indicated for constant nausea for which vomiting does not provide relief. Typically, women with morning sickness have this type of nausea because it is really not a digestive problem."

Sepia officinalis (cuttlefish) is another homeopathic remedy indicated when the thought of food—or even the smell of her husband—provokes a woman's nausea, or when motion provides relief, according to Ullman.

Heartburn And Indigestion
Overindulgence can cause heartburn and indigestion, but pregnancy hormones, which relax smooth muscle tissue throughout the body, including the gastrointestinal tract, also contribute. A relaxed esophageal sphincter can cause heartburn; in the GI tract, slowed digestion can lead to bloating.

For heartburn, Romm recommends Thayers slippery elm lozenges. "They're actually fantastic for heartburn," she says. "Women can take them as needed—six to 10 a day is fine." She also says chewing on raw almonds—"chew them until they're very milky and swallow that liquid"—can help and provide a nutritious snack at the same time.

Arsenicum album (arsenic) or Anemone pulsatilla (windflower herb) are the homeopathic treatments Ullman recommends for heartburn, depending on specific symptoms. Arsenicum is for women whose heartburn is irritating enough that it wakes them up, or if they have generalized anxiety about their health, Ullman says. Pulsatilla is indicated for heartburn triggered by fatty foods and in women who tend to be very emotional, he says.

For slowed digestion, suggest plant enzymes. "If it is indigestion—bloating, stomach upset, that kind of thing—women can try taking plant enzymes to help them digest their food better," says Leslie Beck, R.D., who has a private practice based in Toronto and is author of The Ultimate Nutrition Guide For Women (John Wiley & Sons, 2003).

Constipation
Those pregnancy hormones also can cause sluggish elimination, as can the pressure exerted by the growing uterus. But women are not stuck with it, so to speak. Bulk laxatives are acceptable during pregnancy, but stimulating ones are not. Steer your pregnant customers away from senna, for example, and toward psyllium, bran or flaxseed. Both Romm and Beck say psyllium is a good place to start. Beck recommends 5 to 10 grams of husk mixed with two cups of water up to three times a day.

"Bran is also good during pregnancy—a tablespoon a day mixed into some warm apple juice," says Romm. "For moderate or worse constipation, dandelion root can be used as a gentle laxative." She recommends a strong dandelion root tea or a tincture.

Beck says mixing flaxseed or ground flaxseed powder, 1 to 2 tablespoons up to three times per day, into foods is another gentle way to treat constipation.

Fiber-rich foods, exercise and fluids—at least eight glasses of water a day—will also help keep elimination regular.

Fatigue
Being pregnant is a lot of work, so fatigue is to be expected. For the most part, this tiredness should be "treated" with rest. "It is important for pregnant women not to override that tired feeling, but to sleep," says Romm. "Pregnant women need a lot more rest, up to 14 hours of sleep."

For those who want a safe energizer, there are a few herbs to recommend. "Nettles tea is a little bit of a pick-me-up," Romm says. She recommends brewing a strong nettles infusion and drinking one cup a day. "Nettles can be used during pregnancy," she says. "It supports the adrenal glands and is nutritive, supplying calcium, magnesium and iron."

Herrick says that even though it is controversial whether to take ginseng during pregnancy, she believes when used occasionally for energy, it is fine. Ginseng is definitely a better choice than a cup of coffee, she says.

A little attention to diet can moderate energy levels, too. Not enough iron and protein, or simply not enough calories, can cause tiredness. "Pregnant women should make sure their diet includes all the nutrients, especially plenty of protein and complex carbohydrates, and then check on iron levels because anemia can cause fatigue," Romm says. Because blood volume increases during pregnancy, iron requirements go up as well. Have your customer evaluate her diet and then assess whether her prenatal vitamin regimen is supplying the balance of what she needs.

Prenatal Energizer, made by Santa Cruz, Calif.-based Rainbow Light, features enzymatically active B vitamins, spirulina and other green foods, enzymes and botanicals. "The botanicals in the product were designed to increase stamina and endurance," says Marci Clow, executive director of research and quality. "It has ginger, stinging nettle and American ginseng, which is probably the most effective herb in there for helping increase energy levels." She says it isn't too stimulating, but it does provide a safe boost.

Cold Symptoms
Women often feel helpless when they catch a cold during pregnancy because the remedies they typically reach for are now off limits. But Beck says based on the results of a study published in a 2000 issue of the Archives of Internal Medicine, short-term echinacea use is safe during pregnancy. Echinacea can help reduce the severity of a cold and shorten its duration if taken at the onset of symptoms.

Get Well, another supplement in Rainbow Light's line for pregnant women, is designed to safely help build the immune system. It features vitamin C; a natural algae source of beta-carotene; green foods; an antioxidant blend including elderberries, rose hips and cranberry; and expressed Echinacea purpurea juice. Clow says the product should be taken at the first sign of a cold to lessen its severity and shorten its duration.

It is important to respect the body's wisdom, especially during pregnancy, but some uncomfortable symptoms that accompany pregnancy can be tempered with natural therapies. With the support of an understanding and knowledgeable health care provider, pregnant women can find on your store shelves relief from a variety of discomforts.

Dena Nishek is a Boulder, Colo.-based freelance writer specializing in natural health, home and gardening topics.

Natural Foods Merchandiser volume XXIV/number 9/p. 78, 80, 82