Fertility

Heartburn During Pregnancy: Causes, Safe Treatments, & Natural Remedies

Updated on 30 June 2021 • 7 minute read
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Overview

Heartburn is a common discomfort experienced by 17% to 45% of pregnant women. (1) 

Interestingly enough, some preliminary research suggests that there could be a link between heartburn severity in pregnancy and the amount of hair an infant is born with. (2)

Factors like pregnancy hormones, certain types of food, and medications may trigger or worsen heartburn symptoms. 

Serious complications brought by heartburn during pregnancy seem to be rare (3). Natural or home remedies may help to treat mild symptoms.

On rare occasions, heartburn symptoms might be confused with other potentially serious conditions like pre-eclampsia. 

Keep reading to learn what’s normal and what’s not so you know if and when it’s time to contact your doctor about your heartburn.

 

Pregnancy And Heartburn, Indigestion, GERD, And Acid Reflux – Are There Differences? 

Heartburn is a form of indigestion and has nothing to do with the heart. (3)

It’s a burning sensation in your chest, just below the breastbone, caused by acid reflux, which is stomach acid going up to your throat. (4)

Acid reflux is the actual physical flow of stomach acid back into the esophagus

This acid flow is what causes the burning sensation we refer to as heartburn

If heartburn symptoms happen more than twice a week, a diagnosis of GERD (Gastroesophageal Reflux Disease), or recurrent heartburn, may be made. (5)

Since heartburn is part of GERD symptoms, it may also be a common condition among pregnant women

GERD may not be life-threatening, but it can affect your daily activities like sleeping and eating. (6) 

 

How Common Is Heartburn During Pregnancy

It’s estimated that 50-80% of women complain of heartburn discomfort at some point in their pregnancy. (7) 

Symptoms may become more frequent and severe as you progress to the second and third trimesters. 

Some studies suggest that your chances of experiencing heartburn while pregnant can hover around 22% in your first trimester, 39% in your second trimester, and 60-72% in the third trimester. (1)  

 

Heartburn Symptoms & When Does It Start?

Heartburn, being a symptom of acid reflux, may be coupled with: (4)

  • Unpleasant sour taste in your mouth caused by acid in the stomach
  • Persistent cough or hiccups
  • Hoarse voice
  • Bad breath 
  • Belching
  • Bloating
  • Nausea
  • Stomach pain from hyperacidity

Heartburn in pregnancy can start as early as your first trimester, together with other early pregnancy symptoms like morning sickness and constipation. 

It may be heartburn due to pregnancy if the burning feeling worsens when you lie down or bend over.  

Symptoms are more prevalent in women in their third trimester because the growing uterus puts more pressure on the stomach and intestines. This pressure may push the stomach contents back into the esophagus. (8)

While experiencing heartburn during pregnancy is no fun, it might mean your growing little babe may come out with a nice, thick set of locks. 

According to Dr. Horsager-Boehrer, Chief of Obstetrics and Gynecology at UT Southwestern Medical Center, some research indicates a link between moderate heartburn and babies with full hair. (2)

 

Causes Of Heartburn During Pregnancy And What Makes It Worse

Pregnancy creates several inevitable changes in your body that increase your risk of heartburn and reflux. 

Your growing baby is occupying more space in your abdomen, which pushes your stomach upward and increases abdominal pressure. 

Rising hormone progesterone levels cause your esophageal muscles and LES (lower esophageal sphincter) to relax, thereby slowing down the digestive process. 

The LES is a valve between your stomach and esophagus that prevents stomach acid from going back to your esophagus. 

When this valve relaxes, stomach acid travels back upward and creates irritation of your esophagus lining.

Other factors that can trigger or worsen heartburn symptoms are:

  • Eating late at night
  • Smoking 
  • Being overweight
  • Stress and anxiety 
  • Pain-relievers like Ibuprofen and Aspirin
  • Antibiotics like Tetracycline and Clindamycin
  • Iron supplements
  • Potassium supplements

 

How To Treat Or Prevent Heartburn Naturally During Pregnancy

It might be tempting to go for over-the-counter drugs for quick heartburn relief, but as a pregnant woman, you be extra cautious and make sure that what you are taking in is safe for you and your baby. 

Why not take the natural route first and see if that works?

Here are 7 tips to try.

(Note that the effectiveness of natural remedies may differ for each individual). (9)

 

1. Be mindful of what and how you eat.

Figure out which foods and drinks trigger your heartburn.

Stay away from citrus, vinegar, spicy foods, fatty foods, and carbonated beverages. 

Greasy foods stay longer in your stomach and may force open the muscle that keeps the stomach acid from going back up to your esophagus. (10) 

Sit up while you eat and chew your food slowly and mindfully and in a relaxed manner to avoid digestive pressure on your stomach muscles. 

 

2. Elevate your head while you sleep.

Sleep in such a way that your stomach is under your esophagus to make sure that acid stays in the tummy and doesn’t go upwards.

You don’t need to buy an automatically adjustable bed.

Simply elevate your head while you sleep by putting risers at the head of your bed.

You can also try wedge pillows to elevate your upper body while sleeping.

 

3. Switch from a few large meals to multiple smaller meals in a day.

Large meals linger in your digestive tract and exert pressure on the esophagus muscle.

Try to eat three hours before bedtime, so your meal is already digested by then. 

You could also have your heaviest meal at lunch and a lighter one for dinner. (11) 

 

4. Drink liquids after, not during meals.

Drinking lots of water while eating can quickly fill your stomach. A full stomach may cause acid reflux and the feeling of heartburn. (12) 

 

5. Wear loose clothing.

Tight-fitting clothes can put pressure on your stomach and trigger acid reflux. (12)

 

6. Stop smoking.

Smoking, especially for pregnant women, is harmful. If you’re a smoker and are pregnant or planning to get pregnant, it’s best to quit the habit ASAP.

Tobacco in cigarettes contributes to the relaxation of your stomach muscles and can make acid in the stomach flow back to your esophagus. (13) 

 

7. Try acupuncture.

Dr. Amy Dobbie, a naturopathic doctor, says that: (14)

“Acupuncture is completely safe during pregnancy and is proven to be extremely beneficial and effective. 

In the first trimester, it helps to maintain a pregnancy, nourish the body, and alleviates early symptoms such as fatigue, nausea, and heartburn

Later, the aches, pains, constipation, and swelling that go along with pregnancy can be greatly alleviated by acupuncture treatment as well.

One of the most important times to have acupuncture during pregnancy is the third trimester, to help prepare the body for labor.” 

 

Research also says that acupuncture with herbs effectively relieves acid reflux than proton pump inhibitors. (15)

 

Foods To Avoid & Foods To Eat For Heartburn Relief 

The following are some foods that might help with heartburn and reflux. 

High-fiber foods help you avoid overeating, thus preventing heartburn. (16)

  • Millet
  • Barley
  • Oats
  • Brown rice
  • Corn 
  • Green cabbage
  • Broccoli
  • Legumes like well-cooked lentils and beans
  • Root vegetables like carrots and unpeeled potatoes

 

Non-acidic foods (Alkaline foods) help neutralize strong stomach acid. 

  • Low-acid fruits: apples, bananas, watermelon, cantaloupe, and melon
  • Low-acid vegetables: fennel, sweet potato, beets, cauliflower, radish, and turnips
  • Nuts
  • Ginger

 

High-water foods can dilute and weaken stomach acid.

  • Cucumber
  • Lettuce
  • Watermelon
  • Broth-based soups

 

Beverages that may offer heartburn relief:

  • Non-fat milk
  • Diluted apple cider vinegar
  • Lemon water
  • Ginger tea
  • Aloe vera juice (Look for juice intended for drinking, not the gel from the plant)
  • Check out our Heartburn Rx recipe below

 

Stay away from or limit these foods to prevent heartburn while pregnant:

  • Spicy, salty, and fatty foods 
  • Citrus fruits like lemons, grapefruits, and oranges
  • Tomatoes and tomato-based sauces and condiments
  • Peppermint
  • Chocolate 
  • Carbonated drinks

 

Dr, Ekta Gupta, Director of Endoscopy at John Hopkins Hospital, says: (17)

“Moderation is key since many people may not be able to or want to completely eliminate these foods, but try to avoid eating problem foods late in the evening closer to bedtime, so they’re not sitting in your stomach and then coming up your esophagus when you lay down at night. 

It’s also a good idea to eat small frequent meals instead of bigger, heavier meals and avoid late-night dinners and bedtime snacks.” 

 

What Medications Can I Take For Heartburn That Are Safe For Pregnancy?

Here’s a list of pregnancy-safe medicines for heartburn relief: (18)

  • Mylanta
  • Maalox
  • Tums
  • Rolaids
  • Gas-X/Simethicone, Tagamet (Cimetidine),
  • Pepcid (Famotidine), Prilosec, Prevacid (If no relief from Tums or Rolaids)

(You should use these medications sparingly in the first 14 weeks of pregnancy. Always consult with your doctor or obstetrician before taking any medication, even over-the-counter options.)  

Antacids, H2 blockers, and PPIs (proton pump inhibitors) are the three groups of drugs known to treat heartburn

Antacids such as Maalox and TUMS (calcium carbonate) change the stomach acid to relieve heartburn or indigestion

Pepcid and Tagamet are H2 blockers. These are stomach acid reducers. 

PPIs like Prilosec and Omeprazole also reduce the amount of acid in the stomach.

However, PPIs may take two to four days to take effect fully.

They’re used to treat frequent heartburns or GERD. (18)  

 

While these heartburn medications may provide brief momentary relief, they might cause long-term harm if used for too long, especially in pregnancy. 

Registered dietitian and author of ‘Real Food For Pregnancy,’ Lily Nichols warns against using antacids and acid blockers regularly during pregnancy. 

She says: (19)

“As tempting as it is to just pop an antacid, try to avoid them. 

You have acid in your stomach for several important reasons: to kill harmful bacteria, viruses, and fungi, to help you absorb minerals (like iron and calcium), to digest protein, and to absorb vitamin B12. 

By decreasing the acid in your stomach, you run the risk of food poisoning, digestive problems, and nutrient deficiencies.

Plus, some heartburn is a result of too little acid, not too much.” 

 

If You’re Pregnant Don’t Do This – Heartburn Medications To Avoid During Pregnancy.

Since it’s best to consult your doctor or obstetrician when you’re unsure about what medication to take while pregnant, it’s good to know what unsafe medications to avoid.

Be careful of antacids containing aspirin unless your doctor says it’s fine for you to take it. Also, stay away from antacids with sodium bicarbonate (baking soda) or magnesium trisilicate in them. 

Sodium bicarbonate may cause fluid buildup, and this form of magnesium may not be safe for your baby. (20)

In April 2020, a well-known heartburn medication, Zantac (Ranitidine), was recalled from the market when it was discovered that it contained carcinogens. (21)

 

When To Talk To Your Doctor And Seek Medical Help

If heartburn symptoms are persistent even after natural or antacid intervention, contact your obstetrician or doctor immediately. 

Chronic heartburn that won’t go away with treatment may be indicative of pre-eclampsia, a serious pregnancy complication that requires immediate medical attention. 

Look out for additional symptoms like: 

  • Sudden swelling of your face, hands, or face (edema) 
  • Sudden weight gain 
  • Persistent headache 
  • Trouble breathing 
  • Nausea and/or vomiting
  • Lowered urine levels 
  • Vision problems like flashing lights or blurriness. 
  • Abdominal pain, especially below the ribs 

 

Remedy Recipe: Heartburn Rx Lemonade 

This is an easy-to-make and quite effective home remedy for heartburn. 

Here’s what you’ll need: 

  • The juice of 1organic lemon 
  • 1 teaspoon raw organic honey
  • ½ teaspoon aluminum-free baking soda
  • ½ teaspoon – 1 full teaspoon of apple cider vinegar 

Mix all ingredients in a full glass of alkaline or fresh spring water, drink up, and enjoy! 

It tastes great and can effectively soothe reflux symptoms too. 

 

 

 

References

(1) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4562453/#:~:text=Heartburn%20is%20one%20of%20the,72%25%20in%20the%20third%20trimester 

(2) https://pubmed.ncbi.nlm.nih.gov/17150070/ 

(3) https://pubmed.ncbi.nlm.nih.gov/16225482/

(4) https://www.nhs.uk/conditions/heartburn-and-acid-reflux/

(5) https://utswmed.org/medblog/heartburn-gerd-pregnancy/

(6) https://gastro.org/practice-guidance/gi-patient-center/topic/gastroesophageal-reflux-disease-gerd/

(7) https://pubmed.ncbi.nlm.nih.gov/24012425/

(8) https://americanpregnancy.org/healthy-pregnancy/pregnancy-health-wellness/heartburn-during-pregnancy-982/

(9) https://www.franciscanhealth.org/community/blog/home-remedies-for-heartburn

(10) https://www.health.harvard.edu/diseases-and-conditions/what-to-eat-when-you-have-chronic-heartburn#:~:text=Some%20foods%20and%20ingredients%20may,acid%20out%20of%20the%20esophagus

(11) https://aboutgerd.org/treatment/diet-lifestyle-changes/

(12) https://pearlpoint.org/nutrition-tips-for-managing-reflux-heartburn-and-gerd/

(13) https://www.cedars-sinai.org/blog/what-causes-heartburn-and-acid-reflux.html

(14) https://thewomb.ca/index.php/blog-2/item/should-you-have-acupuncture-during-pregnancy

(15) https://www.nccaom.org/wp-content/uploads/pdf/Acupuncture%20Plus%20Herbs%20Beats%20Acid%20Reflux%20Drug.pdf

(16) https://www.nhs.uk/live-well/eat-well/how-to-get-more-fibre-into-your-diet/ 

(17) https://www.hopkinsmedicine.org/health/wellness-and-prevention/gerd-diet-foods-that-help-with-acid-reflux-heartburn 

(18) https://www.ngpg.org/obgyn/safe-medications

(19) https://commons.und.edu/cgi/viewcontent.cgi?article=1139&context=pas-grad-posters

(20) Nichols, L. (2018). Real Food for Pregnancy. Lily Nichols. 

(21) https://www.uofmhealth.org/health-library/aa130363

(22) https://www.fda.gov/news-events/press-announcements/fda-requests-removal-all-ranitidine-products-zantac-market

 

 

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