I am currently 30 weeks into my third ICP pregnancy. I just started itching but have been diagnosed with ICP per my lab work since around 20 weeks this time. My first pregnancythe itching started at 21 weeks, and my second 18 weeks. Now that I am dealing with the itch for the 3rd time I have a routine down that I wanted to post for future itchy moms. Please note THIS IS NOT MEDICAL ADVICE. While everything I do is based on studies, and consulting with my medical team including a Registed Dietitian, they have approved this for me and my pregnancies. You should consult with your medical team to asses how appropriate any of my 'hacks' are for you, your health, and your pregnancy. These are things I do in ADDITION to taking all my medicationsas perscribed, and going to all of my appointments including my NSTs and BPPs. My first tip is to drink water like its your job. Bilirubinis excreated through urine and feces, so the more you drink the more you will get rid of. My second tip is make sure you are going number regularly. Sequestered bile salts and Bilirubin are excreted in feces, so pooing regularly will make sure bile salts and Bilirubinare being eliminated. These next few suggestions come from my RD. Since bile is excreted when you eat, nutrition can help play a role in managing symptoms. You want to eat a low fat, high fiber (particulalry soluble fiber) diet. Do not extrememly reduce your fat intake, the sudden reduction in demand for bile in your intestines can cause bile acids to build up and spill over more. You still want to demand bile be secreted into your intestines. Over eating fat will increase the amount your body makes, so just be sure to eat it moderation. The soluble fiber will form a gel in your intestines that will bind with and help sequester the bile released into your intestines when you eat. This sequestered bile will then be elminated when you poo instead of being reabsobed into your blood stream. It was also suggested I take 1,200mg of Lecithin a day. My RD suggested I take one 400mg capsule about half an hour before meals. There are multiple studies showing that lecithin assists in the transport of bile from the liver to the intestines. I was told the lecithin does not impact the prescription medications I am on, however you should check with your medical team about medications you are on. Finally my RD suggested adding fruit pectin (think Certo, SureGel, jelly and jam making pectin) to my diet. I mix 3oz into my water or a gatorade each day. The pectin is bitter so I suggestputting it in something flavored. I drink all 3oz at night between dinner and about 2 hours before I go to bed. I started with just 1oz a day and worked my way up as pectin can cause diarhea. I was taking 1oz about half an hour after meals, but that got too hard to keep up with. I was told to separate the pectin from my Ursodiol by 2 hours. The pectin works by binding to and sequestering bile so it doesnt get reabsorbed into the blood stream, and if taken too close to Ursodiol it can impact how well the medication is absorbed into the body. I was told ai can take it wothin 2 hours before I take the ursodiol but cant take it within 2 hours after. Once again please check woth your medical team before adding pectin to your diet. Finally, thanks to other itchy moms suggestions I've found soaking in a warm epsom salt bath before bed helps reduce the itching, and on nights I cant stop scratching Sarna or another menthol containing lotion helps immensely. I hope my tips can help some of you more comfortable, and remembercheck woth your medical team before trying any of these, especiallythe lecithin and pectin.