Excessive salivation, also known as ptyalism or sialorrhea, is a common discomfort that many women experience during pregnancy, especially in the first trimester. While it may be annoying and embarrassing, rest assured that it is a normal part of pregnancy that is not harmful to you or your baby.
In this comprehensive guide, we will cover everything you need to know about managing excessive saliva and stopping spitting during pregnancy.
- Ptyalism is caused by hormonal changes and nausea in early pregnancy. It usually resolves by the second trimester.
- While not harmful, constant spitting can be uncomfortable and socially awkward.
- Lifestyle changes like staying hydrated, avoiding triggers, chewing gum, and using lozenges can provide relief.
- Prescription medications are considered safe options during pregnancy if symptoms persist.
- Work with your doctor to find the right solutions to manage excessive salivation and improve your comfort.
Understanding Excessive Salivation in Pregnancy
Saliva production increases dramatically during the first trimester of pregnancy due to rising estrogen levels and other hormonal changes. Nausea and vomiting, common complaints in early pregnancy, can also trigger excessive saliva production.
As high levels of nausea stimulating the vomiting reflex also cause increased saliva secretion. The bitter taste of stomach acids that accompany nausea can also promote more saliva production to rinse the mouth.
While ptyalism tends to peak during the first trimester, some women may continue to experience excessive salivation throughout pregnancy. The following statistics illustrate the prevalence of this condition:
- Up to 18% of pregnant women experience ptyalism.
- It occurs most commonly in weeks 9-16 of pregnancy.
- Approximately 1-2 liters of excess saliva can be produced per day.
- Symptoms often resolve by the second trimester.
- Only 5% of women deal with persistent excessive salivation in late pregnancy.
Why Ptyalism Causes Spitting
With the influx of extra saliva during pregnancy, spitting becomes necessary to avoid choking or swallowing large amounts of saliva.
As saliva production ramps up, swallowing such copious amounts of thick, frothy saliva can trigger the gag reflex. Spitting out excess saliva prevents nausea and vomiting.
The bitter taste of saliva can also create an unpleasant sensation that makes spitting out saliva preferable to swallowing it.
Frequently needing to spit can cause social anxiety and embarrassment in public settings. The following sections will cover techniques to manage excessive salivation and avoid spitting.
6 Ways to Reduce Excessive Saliva and Spitting
If bothersome ptyalism has you spitting constantly, try these tips to reduce excessive saliva production and improve your comfort during pregnancy:
1. Stay Hydrated
Drinking more water dilutes the saliva and makes it easier to swallow. Aim for the recommended daily intake of at least eight 8-ounce glasses of fluid. Avoid thirst by sipping water regularly.
2. Chew Gum or Suck on Hard Candy
Chewing gum or sucking on sour hard candies like lemon drops stimulates swallowing of saliva. The motion also reduces the pool of saliva building up.
3. Rinse With Baking Soda and Salt Water
Gargling with a baking soda and salt solution neutralizes bitter taste receptors on the tongue to reduce saliva production. Mix 1/2 teaspoon of salt and 1 teaspoon baking soda per cup of warm water. Rinse a few times daily.
4. Use Saliva-Reducing Lozenges
Lozenges containing pilocarpine or lemon-glycerin work to reduce saliva volumes. Allow them to dissolve slowly in the mouth for maximum effect.
5. Avoid Triggers Like Starchy Foods
High-starch foods can irritate salivary glands and make ptyalism worse. Limit bread, chips, pasta, and rice. Eat small, bland meals to prevent nausea-related salivation.
6. Ask Your Doctor About Prescription Options
Medications like scopolamine patches, benztropine, and amitriptyline may be prescribed for severe, persistent cases under medical supervision.
Lifestyle Changes to Manage Ptyalism
Making certain lifestyle adjustments during pregnancy can help minimize triggers for excessive saliva production and reduce spitting behaviors:
Stay Upright After Eating
Remaining upright for 1-2 hours after meals prevents acid reflux and nausea that stimulate saliva production. Elevate the head with pillows when resting.
Avoid Strong Flavors
Spicy, sour, and acidic foods can promote salivation. Stick to mild, bland foods and beverages.
Improve Oral Hygiene
Brush teeth and use mouthwash frequently to combat bad tastes that increase saliva flow.
Dry irritants in the air can stimulate mucus and saliva. Run humidifiers at home and work to add moisture.
Wear Loose Clothing
Avoid tight collars or waistbands that put pressure on the stomach and can worsen nausea and reflux.
Carry Spit Cups or Tissues
When out in public, have spit cups, straws, or tissues handy to discreetly spit out excess saliva as needed.
Get Plenty of Rest
Fatigue exacerbates nausea. Prioritize sleep during pregnancy and take relaxation breaks.
When to See Your Doctor About Ptyalism
You should consult your doctor or midwife if:
- Excessive saliva causes dehydration
- You spit up over 1 liter per day
- Symptoms prevent you from eating/drinking
- You have difficulty sleeping due to spitting
- Prescription medications are needed for relief
Severe ptyalism that persists late into pregnancy may signify:
- Gastroesophageal reflux disease (GERD)
- Nausea/vomiting from hyperemesis gravidarum
- Pregnancy-induced hypertension
- Gestational diabetes
Prompt medical treatment is needed for any underlying conditions contributing to ongoing problematic saliva production in pregnancy.
Medical Treatments for Excessive Salivation
If bothersome symptoms continue beyond the first trimester, your doctor may recommend trying the following prescription medications for relief:
Medications like scopolamine, benztropine, glycopyrrolate, and amitriptyline block acetylcholine, which reduces saliva production.
- Scopolamine is available as transdermal patches.
- Oral tablets or liquid forms can be taken for other anticholinergics.
- Side effects may include drowsiness, constipation, blurred vision.
Pilocarpine stimulates saliva output briefly before reducing it for several hours. This medication comes as oral tablets.
Potential adverse effects include sweating, urinary frequency, and diarrhea.
Steroid medication may be injected directly into salivary glands to shrink tissues and decrease saliva production.
Salivary Gland Botox Injections
Botox injections contain botulinum toxin to block acetylcholine and are administered into the salivary gland. Effects last 3-6 months.
Surgical Treatment When Needed
For severe, debilitating ptyalism causing dehydration, malnutrition, and sleep deprivation, surgical interventions may be warranted.
Salivary Gland Removal
In extreme cases, salivary gland removal surgery may be done after delivery to permanently reduce saliva production.
Salivary Duct Rerouting
Surgically creating a new opening in the salivary duct can help saliva drain out of the mouth more effectively.
What Causes Ptyalism After Pregnancy?
While ptyalism tends to resolve after birth, some new mothers continue to deal with excessive salivation. Postpartum causes include:
- Hormone changes – Estrogen and progesterone fluctuations continue after delivery.
- Nausea – Some women experience ongoing nausea related to adjusting postpartum.
- Medications – Drugs like prenatals, pain relievers, antidepressants.
- Breastfeeding – Nursing can stimulate saliva production.
- Oral issues – Gingivitis, teething, mouth breathing while nursing.
- Stress and anxiety
If excessive saliva lasts more than a few weeks after pregnancy, see your doctor to address the underlying cause.
When to Seek Emergency Care
Along with consulting your doctor about persistent ptyalism, seek immediate medical help if you experience:
- Difficulty breathing after excessive spitting
- Blood in saliva
- Fever, headache, neck stiffness
- Facial muscle weakness
- Swelling around salivary glands
These symptoms may indicate a more serious medical condition requiring prompt evaluation and treatment.
Tips for Coping with Excess Salivation
Having to deal with constant spitting can take a toll during an already challenging time. Here are some tips to help you cope:
- Communicate – Let loved ones know what you are experiencing so they understand.
- Educate – Inform coworkers and strangers as needed about this temporary pregnancy symptom.
- Use humor – Joke about your excessive “drooling” to lighten the mood.
- Carry supplies – Keep spit cups, water, gum, and tissues within reach.
- Take breaks – Step away to spit in private when needed.
- Get support – Join online groups to commiserate and swap tips with fellow moms.
- Focus on the positive – Remember this will pass and your baby is worth it!
Answering Common Questions About Ptyalism
Here are answers to some frequently asked questions about managing bothersome excessive salivation during pregnancy:
Is excessive saliva harmful during pregnancy?
No, rest assured that ptyalism has no negative effects on you or baby! Staying hydrated by drinking fluids is important.
When does excessive saliva usually go away?
For most women, excessive saliva resolves by the end of the first trimester as hormone levels stabilize.
What home remedies help reduce excessive saliva?
Chewing gum, sipping water, rinsing with baking soda and salt, and avoiding nausea triggers can provide relief at home.
Is there medication that can treat excessive saliva in pregnancy?
Yes, your doctor may prescribe anticholinergics or other medications that are considered safe during pregnancy.
What causes excessive saliva after pregnancy?
Postpartum hormone fluctuations, medications, breastfeeding, and oral health issues may contribute to ongoing ptyalism after birth.
How much saliva is too much when pregnant?
Consult your doctor if you produce more than 1 liter per day consistently or if excessive drooling interferes with eating, sleeping or daily function.
When should you call the doctor about excessive salivation?
Contact your provider if symptoms persist beyond 16 weeks, if you become dehydrated, or if you experience worrisome symptoms like fever or facial weakness.
Conclusion: Manage Ptyalism for a More Comfortable Pregnancy
Dealing with excessive saliva and spitting constantly can make an already challenging time during pregnancy more difficult. While ptyalism is a common nuisance, the good news is that it is temporary and harmless. Making lifestyle changes and using home remedies can help reduce symptoms in many cases. For severe excessive salivation causing dehydration or malnutrition, prescription medications or surgical options may be recommended by your doctor.
Remember that this too shall pass! Focus on taking the best care of yourself and nourishing your growing baby. With the techniques in this guide, you can minimize excessive saliva production and avoid constantly spitting during pregnancy. Reach out for support from your healthcare providers, loved ones, and other moms who can relate. Stay positive knowing that this is just a short-term discomfort on the journey to meeting your baby.