Heartburn During Pregnancy

I had the worst heartburn throughout both of my pregnancies, so I tried to gather up a variety of tricks, remedies, and safe medications to keep the burn at bay. Here we go!

Heartburn and acid reflux seem to be one of
the many charming benefits of pregnancy.

There are a couple of reasons
for it, one, as your uterus gets bigger it squishes your stomach and forces
stuff upwards so the acid in your stomach can percolate over. Two, your body is releasing a
number of hormones that relax your joints and muscles so your uterus doesn’t
contract your baby out and so you have an easier birth come show time.

Unfortunately, these hormones also relax the muscles at the top of your stomach
that normally keep the lid on your stomach acid. It can range from mildly annoying
to feeling like you’re gargling battery acid and it sucks.

I had the worst heartburn
throughout both of my pregnancies. The first time around I asked my doctor about
it and she told me to take TUMS. They did nothing and I had to sleep upright
for the last four weeks of my pregnancy – it was beyond awful. Of course I’m an
idiot because when she said “take TUMS”, I heard “TUMS are the only thing you
can take” so I never piped up about how bad it was and lived in misery.

The second time around I told
her I had terrible heartburn again she told me I should take Pepcid AC. I took
it and was perfectly fine the entire pregnancy. It was like the heavens opened

So I tried to gather up a
variety of tricks, remedies, and safe medications to keep the burn at bay. Here
we go:


Tips and Tricks for Heartburn

Eat smaller meals more

The thought being that if you
eat less there will be less stomach acid and therefore less occurrence of acid
“overflow”. I once ate two poutines from New York Fries when I was
pregnant. Two. If you aren’t from Canada you
may not be familiar with poutine. I have no doubt it’s what God eats as Satan
snickers. It is glorious.


Eat slowly and drink your
beverages between meals, not with them:

The idea being that if you
stuff a ton of food in yourself, your body has a lot of work to do to digest it all at
once and releases a lot of stomach acid. If you dilute all that stomach acid
with a bunch of water, your body releases even more stomach acid.


Wear loose, comfortable

I can’t imagine wanting to
wear tight uncomfortable clothes when you’re pregnant (or anytime for that
matter) but it’s mentioned enough that I’ve added it in. So put away that size
0 wet suit and corseted Versace gown to aid in your digestion, you know, until
after the baby comes of course.


Stop eating 2-3 hours before
bedtime (she types laughing):

That way your body isn’t digesting
when you’re lying down. I get it, but I was hungry when I was pregnant – like wolverine
hungry. An apple wasn’t cutting it just before I went to bed. You may have
better luck with this though.


Elevate your head when you sleep:

Keep your head elevated about 4-6
inches while sleeping. You can either do this with pillow, a wedge or using
risers under the feet at the head of your bed.


Sleeping on your left side:

Sleeping on your left side seems to
reduce heartburn as well
. There are a couple of hypothesis
for this. One is that right-side sleeping relaxes the valve between stomach and
the esophagus so acid can flow up. Another is that left-side sleeping keeps the
junction between stomach and esophagus above the level of stomach acid. Either way, it seems to work.

The easiest way to remember is that
“right is wrong”.


Suggested foods that worsen

(basically anything that’s really delicious – sorry, you know I don’t
make the rules here)

  • Tea
  • Coffee
  • Chocolate
  • Carbonated beverages
  • Fried stuff
  • Fatty stuff
  • Spicy stuff
  • Tomatoes
  • Mustard
  • Citrus fruit
  • Alcohol and cigarette smoking
    will also really contribute to heartburn – another reason you should ditch
    those habits all together.


Suggested foods that improve

  • Milk (I found this actually gave
    me heartburn, but I may be alone in that one)
  • Yogurt
  • Ice Cream (Always worth a try
    – better eat two tubs just to be sure)
  • Basil leaves
  • Ginger in any form – root,
    chewables, tea
  • Apples
  • Pineapple and papaya (ripe papaya only but who the hell eats unripe papaya?)
  • Raw Almonds
  • Honey
  • Fermented foods
    such as sauerkraut,
    kimchi, and pickles 
  • Fermented
    drinks like milk kefir,
    kombucha, and water kefir soda
  • Chewing gum – Although, some sites say it will actually encourage stomach acid production which will exacerbate your heartburn.


Heartburn Remedies

Apple Cider vinegar and honey: Mix 8 oz
of water with two teaspoons apple cider vinegar. Add honey to taste.

Papaya enzymes or Digestive enzymes: The idea being your stomach
is helped along so it doesn’t have to release as much acid.


Heartburn Medications:


(Tums, Rolaids, Milk of Magnesia)

These help by neutralizing stomach acids and are generally deemed
safe for use during pregnancy. That said, some seem to be better choices than
others so read your labels and check with your medical profession before going
rogue with them because they can interfere with other medications, iron
supplements, etc. The most common ingredients in antacids are:

  • Calcium carbonate: This ingredient has
    been used for heartburn since the first century and is deemed safe for pregnant
  • Magnesium Hydroxide: Seems to be deemed
    safe for pregnancy, plus it can help with constipation. Woot! Some sites say you should dial it back
    in your third trimester because it can slow uterine contractions however, there
    are quite a few magnesiums and I’m not convinced they aren’t getting them
    confused. I still thought it was worth mentioning because if you know your
    magnesiums really well, you can let me know which is correct and I can update


Acid Blockers:

Okay, instead of neutralizing acid,
these guys reduce the amount of acid your stomach produces. They are H2 blockers
and Proton Pump Inhibitors (PPI) – they differ slightly in what stage of acid
production they deal with, how long they take to kick in, and how long they

Both have been given the green light
for pregnancy, however H2 blockers have been around longer than PPIs so there’s
a bit more data on them.

The difference between the
over-the-counter brands and their prescription counterparts is their potency.

The ones that seem to be the most popular with medical
professionals are:

  • Pepcid AC (OTC – over the counter)
  • Zantac (OTC)
  • Prilosec (OTC)
  • Pepsid (H2)
  • Protonix (PPI)
  • Nexium (PPI)
  • Dexilant (PPI)


Stuff that is Dicey or a No-No

Fennel Seed Tea: This got a few thumbs
up and a few thumbs down. As you know with most herbs, you can’t patent them so
nobody is doing large scaled studies on them and that makes people
understandably twitchy. Find someone that knows what they are talking about
with this stuff before going this route.

Slippery Elm: Again, everything
herbal often has conflicting  information because these remedies aren’t studied to the
extent other drugs are. I’ve read everything from slippery elm being completely
safe to it being use with caution. It sounds fine but ask a person that knows their shit (preferably someone that wears their long grey
hair in a braid) before drinking a bathtub full of it.

Deglycyrrhizinated Licorice
Okay, this one sounds fine but the reason I put it in here is because
Licorice is not fine (the root, not the candy – they flavor that with anise so
it’s perfectly safe) and I don’t want anybody getting them confused. Licorice has something
called glycyrrhizin in it and it can elevate your
blood pressure and increase water retention – bad
bad no – whereas DGL has had the glycyrrhizin removed so it’s safe to treat
heartburn. Talk to grey braid person and your medical pro to make sure you’re
taking the correct stuff.

Salicylate or acetylsalicylic acid (Alka
This one is a no-no because it contains
aspirin, which can interfere with your blood’s clotting
action during pregnancy.

Sodium bicarbonate (baking soda): Many, many sites will tell you to take
baking soda in a glass of water to neutralize stomach acid. The problem is
baking soda causes water retention in both you and your baby. The last thing a
pregnant lady needs is water retention. Baking soda actually has a category C
rating for pregnancy from the FDA, if you can believe it. Don’t worry, you can
still bake your cookies, just don’t drink glasses of it.

Aluminum hydroxide or aluminum
carbonate (Mylanta, Maalox): 
It looks like this ingredient isn’t so
much dangerous as it can contribute to constipation, so you’re better off going
with the other alternatives.

So hopefully something here will help extinguish the burn and you won’t be an idiot like me and just power through like some kind of dum dum martyr. 

Let me know what you’ve had success with though and keep trying the ice cream method until it works!

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  • Second pregnancy and I am saved again by this anti-reflux medicine we find almost anywhere in the world, except apparently in North America: It’s called Gaviscon and it bring instant relief. It is safe to use during pregnancy (says my obgyn and the sticker on the bottle).

  • I drink raw organic apple cider vinegar in water with a little honey every morning before eating or drinking anything else and it’s like magic! No more heartburn/reflux. It usually lasts all day, but you can always take more later if needed.

  • Thanks for the great information. Here’s how I totally reversed my heartburn and acid reflux:

    1. Take a half teaspoon of baking soda in a glass of water. Helps neutralize stomach acid.
      2. Drink 1/2 cup aloe vera juice before a meal. Reduces inflammation.
      3. Watch this video on http://www.journalofnaturalhealth.com/heartburn
      and follow the steps. Your heartburn or acid reflux symptoms should be gone in about a week.
      4. Take it easy once you are reflux-free. Watch what you eat (don’t go crazy with this, of course!)

    I struggled for many years with acid reflux and it’s not easy to overcome it, but if you really want to, you can do it.

  • There are many natural remedies for heartburn including: chewing gum, baking soda, licorice, aloe, slippery elm and olive oil. There is a new natural supplement called Episolve GI (www.episolvegi.com), which uses extra virgin olive oil.

  • Oddly, watermelon has been working wonders for my heartburn. I don’t know if it’s the coolness or the juiciness of it or if it’s purely placebo, but a couple of chunks of watermelon and that heartburn just cools right off. Warning: Eating watermelon before bed increases middle-of-the-night bathroom trips by about 75%!

  • I suffer from acid reflux and chronic heartburn. I take Zantac everyday and it does help however some days it’s really bad and I have found that drinking a can of Sprite works wonders!! It helps to make me burp and it definitely relieves the pain.

  • Thank you for this extremely useful article! I’ve never tried chewing gum, and am really hoping that helps. Dairy actually seems to make the burning pain worse for me :(.

    Here is another site I found that really helped me, especially with choosing a specific wedge pillow for sleeping slanted: http://tomorrowhealth.com/cure-heartburn.

    I can’t wait to feel better.

  • Thank you so much for this, truly truly helpful! One comment re Magnesium Hydroxide – I’ve been taking it for years, regularly, in small doses, to help with heartburn and constipation due to constant traveling. Now that I am pregnant though, I got scared off it as I read that it inhibits absorption of both iron and folic acid (says so on MH wikipedia page) It is, however, the ONLY thing that helps with my pregnancy burping and it does help out the bowel as well. Do you know anything about the interaction with folic acid and iron? Thank you for sharing! FN

  • Hi there. We’ve got a great natural antacid for heartburn called Axia3. You can get it at Whole Foods and lots of online retailers. Axia3 is very different from traditional antacids because it is formulated with an exclusive blend of natural ProDigestive enzymes that work with your body’s digestive system. You can read more on our website. Also, through August you can get a free roll of Axia3 and a Whole Foods Market near you. If you have any questions you can email us at customerservice@axia3.com http://www.axia3.com/whole-foods-market-give-away/

  • I too suffer from terrible, near constant heartburn, and was also told "take TUMS" by my physician. As one commenter said, the effect was similar to "putting a band-aid on a decapitation." I’ve found ice cream actually does work (and you’re pregnant so no guilt, right?) as well as eating cereal or thick-grained bread. Lying on my left side also works wonders for me as well. Thanks for all the other great tips!

  • Hi,
    Is the apple cider vinegar in raw/organic form safe? It says unpasteurized on the bottle. Or do I need to get a diff one?

  • Believe it or not I have found ‘Love Heart’ sweets really help, they’re chalky and delicious. My friend told me about them and I couldn’t believe it due to thinking they were fizzy but, Alas! no, they’ve been my saviour.

  • I’m surprised no one has mentioned peppermint yet. It’s a great alternative for mild indigestion and it’s delicious! Peppermint (1) may activate an anti-pain channel as well as (2) calm muscles – thanks menthol! – and encourage bile flow that is important for digesting fats. Always check with your medical physician first, though.


    Yum: (1) http://www.sciencedaily.com/releases/2011/04/110419101234.htm (link to peer reviewed PAIN journal in the article)
    (2) http://www.umm.edu/altmed/articles/peppermint-000269.htm

  • I was mainlining huge Tums (the 1000mg kind) for, oooh, two months or more to no avail –– I mean, they’d do the trick at the time, but you’d be back for more at every meal and snack. I was also eating a lot of extra ‘helpful’ food – almonds, glasses of milk, yogurts, ice-cream – to quell the effects of the heartburn and gaining weight I don’t think I would have gained, so wasn’t too happy. Plus, nothing was working at night.

    I thought this was just one of those things you had to suck up, and mentioned it only in passing to my OBGYN consultant, who said * here comes the important part*:

    ‘Taking huge amounts of antacids can do really, really strange things to your body chemistry and blood work and knock your electrolytes out of whack. We don’t like it because then we can’t tell what’s acutally going on with you. It’s much better if I just write you a prescription for an acid-blocker you take once every day.’

    The prescription was cheap (€10 in Ireland) and it’s one pill per day, no side-effects. I have NO heartburn now, no Tums addiction and no extra snacks – other than the ones I want, of course 🙂

  • I am coming up on 36 weeks and my doctor eventually put me on Protonix when the heartburn was (just one more thing) keeping me from sleeping. It turns out I come by epic heartburn honestly–there are pictures of my eldest aunt drinking Milk of Magnesia straight from the bottle while pregnant.

    Here was the progression:
    I mainlined TUMS for the first trimester and a half. Finally, my doctor said, "It’s not like a lot of TUMS is bad for you…it just clearly isn’t working."

    She had me try Zantac…well, its generic. That worked as long as I was religious about the dose times. And then it stopped working.

    Protonix is weird. It feels like I’m still having roughly the same reaction to food (all food–this heatburn doesn’t discriminate), but it doesn’t hurt. I can still feel the reflux, but without the burning. Which is AWESOME, but also really creepy for me. I am not comfortable with medications in general, so YMMV.

  • This might sound crazy, but I have found carbonated sodas really help with my heartburn. It’s such a relief to burp!

  • It’s like you knew exactly what I needed to hear about today. I had the worst heartburn of my life over the weekend and I’m only at 16 weeks! I’m fairly certain the culprit was a tall glass of orange juice. At one point I start munching on some mint gum and that relief was instantaneous, although the relief went away as soon as the gum started losing flavor. I might need to start buying gum in bulk. Thanks for the other tips!

  • I took Nexium before I got pregnant. I was actually tested for pregnancy over a year ago before they would put me on it, because it’s not safe for pregnancy. I was told by the NP I saw to confirm my pregnancy to stop taking it if I hadn’t already. However, it’s only available by prescription, so it’s not really an issue, but I thought I’d mention it. There are OTC versions of it though, so I would check with a doctor before taking those too. There are prescription reflux meds that are safe for pregnancy though. I just know about Nexium. I’d be surprised if a doctor prescribed it to a pregnant woman. I would be suspicious of that doctor, as everyone I’ve talked to, including the OB I nanny for, says it’s not safe. Just FYI 🙂

    • Well, that just applies to unripe papaya and I felt it was a little bit of "baby out with the bathwater" by saying to avoid it during pregnancy. Ripe papaya is a great source of vitamin A and C and it was mentioned many times as a treatment for heartburn for pregnant women — both the fruit and the enzymes, but here’s another study on it that goes into a little more details about the unripe study (poor rats eating unripe papaya – blech) http://www.ncbi.nlm.nih.gov/pubmed/12144723

      • unripe — or green — papaya is used a lot in thai dishes (and maybe other asian cuisines, not sure). so that’s the place to look out for it.

  • I also had terrible heartburn during my pregnancy. I was on ranitadine, but I found pineapple also helped, but it’s one of the few fruits you should eat AFTER you eat (I think if you eat it on an empty stomach it can actually make heartburn worse). Two weeks before my due date I ate around one pineapple a night (along with a tub of ice cream of course ;)).

  • I’m 35 weeks pregnant and heartburn is been killing me lately. The apple cider vinegar, honey and water concoction may just be the cure I was looking for! Thank YOU!!!

    • I meant, heartburn has been killing me lately. I was so excited to find something (other than ice cream) that helps that I, apparently, lost the ability to type.

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