Things to take for heartburn while pregnant

More than half of pregnant women get serious heartburn, particularly during their second and third trimesters. Heartburn, also called acid indigestion, is an irritation or burning sensation of the esophagus (the tube that carries food and liquid to your stomach when you swallow). It’s caused by stomach contents that reflux (come back up).

Symptoms of Heartburn During Pregnancy

If you have heartburn while you’re pregnant, you may:

  • Feel burning or pain in your chest or throat, especially after you eat
  • Have sensations of fullness, heaviness, or bloating
  • Burp or belch
  • Have a sour or bitter taste in your mouth
  • Cough or have sore throat

Causes of Heartburn During Pregnancy

Heartburn in pregnancy may happen because of changing hormone levels, which can affect the muscles of the digestive tract. 

Pregnancy hormones can cause your lower esophageal sphincter (the muscular valve between the stomach and esophagus) to relax, allowing stomach acids to flow back up into your esophagus. Also, as your baby grows, your enlarged uterus can crowd the abdomen, pushing stomach acids upward. Although it's rare, gallstones can also cause heartburn during pregnancy.

Prevention of Heartburn During Pregnancy

Some tips that may help you cut down on heartburn during your pregnancy include:

  • Eat several small meals each day instead of three large ones.
  • Eat slowly.
  • Avoid fried, spicy, or rich (fatty) foods or any foods that seem to cause relaxation of the lower esophageal sphincter and increase the risk of heartburn.
  • Don’t smoke tobacco or drink alcohol, which can make heartburn symptoms worse.
  • Drink less while eating. Drinking large amounts while eating may increase the risk of acid reflux and heartburn.
  • Don't lie down directly after eating.
  • Keep the head of your bed higher than the foot of your bed. Or place pillows under your shoulders to help prevent stomach acids from rising into your esophagus.
  • Wear loose-fitting clothing. Tight-fitting clothes can increase the pressure on your stomach and abdomen.
  • Try to avoid constipation.

Treatment of Heartburn During Pregnancy

If your heartburn won’t go away, see your doctor. They may prescribe or recommend OTC medications that are safe to take during pregnancy. Heartburn usually disappears following childbirth.

Medications may include:

Over-the-counter antacids such as calcium carbonate or magnesium hydroxide. These are generally safe to use during pregnancy. You may find that liquid heartburn relievers are more effective in treating heartburn, because they coat the esophagus.

H2 blockers. These medications block chemical signals that produce stomach acid. They include cimetidine (Tagamet) and famotidine (Pepcid, Zantac 360), and they’re available in over the counter and prescription strengths.

Proton pump inhibitors (PPIs). Like H2 blockers, these drugs help cut down on stomach acid. PPIs, which include lansoprazole (Prevacid) and omeprazole (Prilosec), are available over the counter and by prescription.

If you take iron supplements, talk to your doctor before you take a PPI or H2 blocker. These medications can make the supplements less effective.

Heartburn Medication to Avoid During Pregnancy

Talk to your doctor before taking any antacids. Some contain ingredients that may harm you or your baby. Be sure to not to take these medications:

Ranitidine. In 2020, the FDA stopped sales of an H2 blocker called ranitidine (the ingredient in older Zantac products) because it was contaminated with a cancer-causing agent. If you take OTC ranitidine, stop your use. If you have a prescription for ranitidine, talk to your doctor about other options before you stop your medication.

Heartburn during pregnancy will plague most moms-to-be at some point because progesterone, the hormone that relaxes muscles in pregnancy, also relaxes the stomach valve that keeps acid out of the esophagus. In addition, the growing uterus crowds the stomach, forcing acid into the esophagus.

But there are safe, effective ways to stop it. "Pregnant women really don't need to suffer with heartburn anymore," says Adrienne Einarson, RN, assistant director of clinical services at Motherisk, a Toronto-based program that investigates the effects of prenatal exposures on maternal and fetal health. Here, experts recommend 12 different ways to (safely!) soothe heartburn during pregnancy.

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If you're suffering from morning sickness, eating just a little at a time is probably no problem for you. But if your appetite is healthy, be sure to avoid eating so much that you feel full.

Just as it does when you're not pregnant, an overly stuffed stomach can contribute to heartburn. Instead of three square meals a day, try five or six smaller ones.

Bolting down your food can also lead to heartburn and indigestion. Try to relax and enjoy your meals, which will also help you avoid overeating.

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Rather than drinking a big glass of milk with dinner, you may be better off just sipping liquids during meals. Try to get most of your fluid intake by drinking beverages between, rather than during, meals.

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After a meal, take a leisurely walk, do a little housework, sit down and read a book—just don't lie down, and don't do anything that requires you to bend over. Both of these activities can help wash acid back up into your esophagus.

Having a hearty meal and then heading to bed is a recipe for heartburn, warns Joel Richter, MD, director of the division of gastroenterology and nutrition and the esophageal diseases center at the University of South Florida, in Tampa, who has studied heartburn during pregnancy. He recommends trying not to eat for at least three hours before you go to sleep. You should also try to avoid liquids starting a few hours before bedtime.

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Many people with acid reflux swear by their "bedges," wedge-shaped pillows that gently slant your upper body upwards to keep stomach acid where it belongs.

  • And there's no need for buying a pricey special product, Dr. Richter says. "You can get these at places like Bed, Bath and Beyond for about $25," he says. We like the Boppy Pregnancy Wedge ($16; amazon.com).

Fat, caffeine, chocolate, citrus—pregnant women with heartburn have been advised to avoid all of the above at one time or another. But what causes reflux in one woman might not be a trigger for another.

Rather than tell his pregnant patients to avoid a specific food, Dr. Richter says he advises them to stay away from foods that specifically aggravate them. Everybody's different, Dr. Richter says. Some pregnant women can chow down on spicy Mexican food or a plate of spaghetti and meatballs with no ill effects.

Wearing tight clothing is only going to put more pressure on your already crammed abdomen, and could possibly worsen acid reflux.

Opt for the loose-fitting maternity wear, especially if you're trying to stamp out heartburn. We love the gorgeous maternity clothes from HATCH (they're designed to flatter both before, during, and after pregnancy), or Isabel Maternity by Ingrid & Isabel for a more affordable option.

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Some women find that ginger—ginger ale or ginger candies, such as Chimes Ginger Chews, for example—can help ease an upset tummy.

This spice can also combat nausea and vomiting, which often go hand-in-hand with heartburn.

Although there's not much scientific evidence for ginger as a remedy for pregnancy woes, Einarson says, it is safe to consume when you are pregnant.

If lifestyle changes don't cut it, over-the-counter antacids may quell your heartburn symptoms.

Antacids containing calcium or magnesium should be safe to take during pregnancy. In fact, the extra calcium in antacids like Tums is good for mom and baby.

But avoid antacids that contain aluminum because it can cause constipation and be toxic at high doses. Steer clear of sodium bicarbonate (baking soda) as well—it can cause swelling.

If an antacid isn't working, it may be time to consider stronger medications.

Your first option will likely be an H2 blocker like Tagamet or Zantac. These drugs suppress stomach-acid production. All four H2 inhibitors on the market are now available without a prescription and considered to be safe during pregnancy. But talk to your doctor before taking them.

"They really work," says Einarson. "You only have to take one or two a day."

If other medications don't help, there are also proton pump inhibitors (PPIs), such as Prevacid. These have a more powerful acid-suppressing effect than H2 blockers, and most are available over the counter.

Although PPIs are, in general, safe for pregnant women, animal studies have raised concerns that omeprazole (Prilosec) could harm a developing fetus, Dr. Richter says. "My recommendation to patients would be to avoid that one because there are about five or six out there on the market, with the H2 blockers," he says. "All of them look to be safe during pregnancy."

Be sure to discuss any medications with your doctor.