How To Relieve Heartburn During Pregnancy

Heartburn is common in the second trimester, and it can get worse as your belly grows. Learn what causes it and how to get pregnancy heartburn relief, especially at night.

Heartburn During Pregnancy
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As the name implies, heartburn (also known as acid reflux) is a burning sensation in your chest, but it has nothing to do with your heart. It happens when the lower esophageal sphincter (LES), a muscle responsible for keeping stomach contents in place, begins to relax or leak. This allows stomach acids to flow upward into the esophagus, explains Suzanne Trupin, MD, CEO of Women's Health Practice of Champaign, Illinois.

Unfortunately, most pregnant people will experience some acid reflux, especially in the second half of their pregnancy, says Shari Brasner, MD, assistant professor of obstetrics and gynecology at Mount Sinai School of Medicine, in New York City. Having this unpleasant sensation may happen sporadically or daily—and tends to get worse as your baby grows.

Heartburn usually appears after meals or at bedtime, and it can range from uncomfortable to agonizing. Understanding the causes and employing prevention strategies can help ease symptoms. Here's what you need to know about heartburn in pregnancy, including how to find relief for pregnancy heartburn at night.

Causes of Heartburn During Pregnancy

Pregnancy hormones are largely responsible for the heartburn that plagues many pregnant people. High levels of progesterone cause the muscle that sits between the esophagus and stomach to relax. "When this happens, acids from your stomach can move upward more easily," says Jill Maura Rabin, MD, associate professor of clinical obstetrics and gynecology and women's health at the Albert Einstein College of Medicine, in New York City.

What's more, your growing baby exerts pressure on both the stomach and the LES, increasing the chance that acids will be pushed up into the esophagus. When the growing uterus presses up against the stomach, it has less room to do its job.

Top Strategies for Pregnancy Heartburn Relief

Heartburn is a common pregnancy complaint that is often worse at night and soon after eating. Follow these five tips to get relief from the pain of pregnancy heartburn:

  • Eat less, more often
  • Eliminate trigger foods
  • Focus on fluids
  • Sleep smart
  • Take antacids mindfully

Eat less, more often

Overeating exacerbates heartburn, says Rachel Brandeis, MS, a registered dietitian in Atlanta who specializes in prenatal nutrition. "When you're pregnant, there's less room for your stomach to expand," she explains. Maintaining a well-balanced diet will not only stave off heartburn in the short term but throughout your pregnancy as well.

Gaining more weight than recommended also puts more pressure on your abdomen, which can trigger the condition. Instead of three meals a day, aim for six mini-meals of no more than 1.5 cups of food each, Brandeis recommends. Smaller meals are easier for your body to digest, which can help to relieve heartburn symptoms during pregnancy.

Eliminate trigger foods

Identify the foods that intensify your heartburn and try removing them from your diet. While there are no universally "off-limits" foods, common heartburn triggers include acidic foods (such as citrus fruits and tomatoes), greasy or fried foods, spicy foods, chocolate, coffee and carbonated beverages, and alcohol (which, as you well know, you should eliminate anyway!).

Focus on fluids

"Liquid-y foods are less likely to cause problems than solids since they move through the stomach more quickly," says Brandeis. Soups, smoothies, yogurt, milkshakes, protein shakes, and puddings are good choices. Look for liquids that offer plenty of protein, such as milk and drinkable yogurt, and aim to make solids a little less so: "Chew solid foods slowly and extremely well, until they're almost liquefied," recommends Brandeis.

While you may want to increase the amount of liquid foods, drinking large quantities of fluids with meals can actually aggravate heartburn. This happens because drinking can cause you to swallow more air. If you feel thirsty during a meal, take small sips between bites of food.

Sleep smart

To avoid nighttime heartburn during pregnancy, don't eat anything for at least three hours before bedtime. Laying in a horizontal position makes it easier for acids from your stomach to travel up to your esophagus. For pregnancy heartburn relief at night, try elevating your head and upper body on stacked pillows. If you're not already sleeping on your side, start now; stomach acids will have to travel uphill to reach the esophagus—no easy feat! Pregnant people should also try to avoid lying down or bending over right after eating.

Take antacids mindfully

Antacids can help neutralize the acid in your stomach to treat your heartburn fast. Finding relief with over-the-counter medications like Tums, Rolaids, or other calcium-containing antacids is safe. However, "too much calcium can block iron absorption, so don't take Tums at the same time you take your prenatal vitamin," Brandeis advises. Also, avoid antacids that list aluminum (such as aluminum hydroxide or aluminum carbonate) as an ingredient as it can cause constipation and even be toxic in large doses.

Remedies containing aspirin (such as Alka-Seltzer) should also be avoided during pregnancy, particularly in the first trimester. Avoid products with salicylate or acetylsalicylic acid in the ingredient list. You don't want an antacid containing sodium bicarbonate (baking soda) or sodium citrate either. Both are high in sodium, which causes water retention.

But before rushing out to the nearest pharmacy, be sure to get your doctor's OK before taking antacids or any other medications during pregnancy. Don't hesitate to consult a health care provider about your heartburn symptoms. They can help you come up with other safe strategies to find relief.

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Sources
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  4. Evidence-based treatment recommendations for gastroesophageal reflux disease during pregnancy: A review. Medicine (Baltimore). 2022.

  5. Alka-Seltzer. DailyMed.

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