How to deal with heartburn during pregnancy

What causes heartburn during pregnancy?

Hormonal changes during pregnancy can affect the body in a number of ways. Progesterone, the hormone your body produces to keep the lining of your uterus thick during your pregnancy, also relaxes the valve between the stomach and the oesophagus, allowing stomach acid to pass through more easily. This can cause uncomfortable feelings such as nausea or a burning sensation.

Later in pregnancy, the pressure of the growing baby on your stomach can also force stomach acid or food back up the oesophagus. This is one of the reasons pregnancy heartburn is more common in the third trimester.

How to get rid of heartburn during pregnancy

Luckily, you shouldn't have to put up with pregnancy heartburn - and there are lots of ways in which you can help yourself. GP Dr Julie Coffey recommends the following natural aids:

Eat smaller meals

"As your baby grows, functional stomach size is reduced. If you eat large meals, reflux into the oesophagus is more likely. Try reducing your portion size to alleviate the problem."

Avoid excessive snacking

"Although you may be eating smaller meals more frequently, you should avoid snacking between these meals. This will give the stomach a chance to digest and empty from one meal before starting again with new food, reducing your risk of indigestion," Coffey suggests.

In a recent Patient survey of over 400 healthcare professionals, 85% of respondents recommended dietary changes to manage heartburn symptoms in pregnancy.

Drink plenty of water

It's tempting to reach for a medicinal remedy, but it's worth trying to drink several glasses of water in the first instance.

"This dilutes stomach acid so that it causes less irritation. It's amazing how this straightforward trick can settle both indigestion and heartburn."

Prop yourself up at night

62% of healthcare professionals said that sleep position was important when it comes to managing heartburn in pregnancy.

"One thing that may trigger pregnancy heartburn is lying down at night," points out Coffey. "Raising your sleeping position so that you are on a slight tilt will make it harder for stomach acid to travel up the oesophagus. Gravity alone can sort out night-time heartburn."

But don't be tempted to use pillows to do this - you don't want your chest propped up while your stomach is flat, as this can put more pressure on the top of the stomach. Instead, prop the head of the bed up on a couple of bricks.

Stop smoking and give up alcohol

As well as potentially causing harm to your baby, smoking and drinking during pregnancy can aggravate heartburn.

"Doctors advise that you give up both of these substances during pregnancy. For support in giving up, speak to your midwife or doctor," she says.

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What's causing your heartburn? Acid reflux diet sheet

If you have a burning pain in your chest or travelling up your throat after eating, you're probably experiencing acid reflux - a feeling more commonly described as heartburn. Some foods are more likely to trigger this annoying and uncomfortable symptom. So, if it keeps revisiting you after meals, it may help to look at how you eat as well as what you eat.

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Acid reflux and oesophagitis

When acid from the stomach leaks up into the oesophagus (tube carrying the food from the mouth to the stomach) the condition is known as acid reflux. This may cause heartburn and other symptoms. A medicine which reduces the amount of acid made in the stomach is a common treatment and usually works well. Some people take short courses of medication when symptoms flare up. Some people need long-term daily medication to keep symptoms away.

by Dr Pippa Vincent, MRCGP

When to see your doctor for pregnancy heartburn

If you are suffering from persistent pregnancy heartburn that isn't relieved by any of the natural methods above, you may need to take medication for pregnancy heartburn relief. However, before taking any tablets during pregnancy, it's advisable to speak to your midwife, GP or a pharmacist for advice. Whilst the right antacid may ease symptoms, some may interfere with the absorption of certain nutrients such as iron, or interact with other medications.

Doctors also recommend avoiding antacids that contain magnesium during the third trimester of pregnancy, as this mineral may interfere with contractions.

Complications of heartburn during pregnancy

In some cases, pregnancy heartburn persists despite antacid treatment or leads to additional problems such as weight loss, stomach pain or problems with eating. If you find you are still suffering - particularly if your pregnancy heartburn is severe, causes coughing, night-time waking or you experience dark-coloured stools, it's important to speak with your GP.

Your GP may decide to prescribe a stronger medication to reduce the amount of stomach acid. Omeprazole is considered safe during pregnancy and should help your symptoms to improve. And it's not just about comfort - if acid continues to escape into the oesophagus, this may cause damage over time, so it's important to seek help.

Whilst 80% of women are thought to experience heartburn during pregnancy, there's no need to suffer in silence. Following our advice should help you to manage your symptoms and concentrate on more important things!