Can't Keep Water Down for 24 Hours: What to Do
If you haven't been able to keep any water down for 24 hours, this isn't something to wait out — it's a sign you need medical help today. Being unable to hold down fluids for a full day puts you at real risk of dehydration, which can affect both you and your baby, so it's important to know what's happening and what to do next.
Why this happens
Vomiting that stops you keeping fluids down at all, rather than the more common "morning sickness" that comes and goes, is often a sign of hyperemesis gravidarum (HG) — a more severe form of pregnancy sickness. Unlike typical nausea, HG involves persistent vomiting that can lead to weight loss, dehydration, and an imbalance of the body's salts (electrolytes). It usually starts around 6-9 weeks and can continue well into the second trimester, though it varies hugely between women.
Signs you're becoming dehydrated
Watch for these alongside the inability to keep fluids down:
- A dry mouth, dry lips, or reduced skin elasticity
- Dark yellow or strong-smelling urine, or passing very little urine
- Dizziness or light-headedness, especially standing up
- A rapid heartbeat
- Feeling unusually weak or confused
- Headache that won't shift
What to do right now
- Contact your GP surgery or midwife today, or call NHS 111 if it's out of hours — don't wait to see if it improves on its own.
- If you feel very unwell, are unable to stand, or the symptoms come on very suddenly and severely, go to A&E.
- While you wait for advice, try sipping tiny amounts of water or an oral rehydration solution every few minutes rather than drinking a full glass at once — small, frequent sips are easier to keep down than large volumes.
- Avoid strong smells, rich or greasy food, and anything that has previously triggered your sickness.
What treatment looks like
If you're assessed and found to be dehydrated, treatment typically involves intravenous (IV) fluids to rehydrate you quickly, anti-sickness medication that's safe in pregnancy, and monitoring of your salts and ketone levels. Some women need a short hospital stay; others are treated and go home the same day with medication to manage ongoing symptoms. This is a recognised and treatable pregnancy complication — you are not overreacting by seeking help.
Frequently Asked Questions
What should I do if I can't keep water down for 24 hours?
Contact your GP or midwife today, or call NHS 111 out of hours — don't wait for it to pass. If you feel very unwell, faint, or the vomiting is severe and sudden, go to A&E. You may need IV fluids and anti-sickness medication to rehydrate you safely.
Is not being able to keep water down a sign of hyperemesis gravidarum?
It can be. Hyperemesis gravidarum involves persistent vomiting that prevents you keeping food or fluids down, leading to dehydration and weight loss. It's more severe than typical morning sickness and needs medical assessment and treatment, so it's always worth getting checked rather than assuming it will settle by itself.
How is severe pregnancy sickness treated?
Treatment usually starts with rehydration, often via IV fluids if you're seen in hospital or an urgent care setting, alongside anti-sickness medication that's considered safe in pregnancy. Your team will also check for ketones and electrolyte imbalances. Many women need ongoing anti-sickness medication at home once rehydrated, and some need repeat visits if symptoms return.
This article is for informational purposes only and does not constitute medical advice.
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