Medically Reviewed by: Midwife Pip, MSc BSc
Heartburn is one of the most common symptoms in pregnancy, with up to 80% of women experiencing it at some point in their pregnancy journey. Some women get heartburn just a few weeks into their pregnancy, while others find it starts in the third trimester when their bump is expanding and there's less room for food.
While heartburn in pregnancy can be painful, the good news is that you may be able to ease it with lifestyle changes or medication. We've spoken to retired specialist midwife and baby & parenting expert, Rachel Fitz-D, to explore the symptoms, causes and treatment of heartburn related to pregnancy, as well as the ways you can avoid it in the first place.
What is heartburn?
Heartburn is a burning sensation in the chest caused by acid reflux, which is where the stomach acid is pushed up towards the throat. If it's particularly severe it may be gastro-oesophageal reflux disease (GORD). Heartburn can also be a symptom of indigestion which is pain or discomfort after eating.
What are the symptoms of pregnancy heartburn?
According to the NHS, the symptoms of heartburn during pregnancy include:
• Feeling full or bloated
• A burning sensation or pain in the chest
• Feeling sick or even being sick
• Increased burping
• Bringing up food
What are the causes of pregnancy heartburn?
There is no one cause of heartburn in pregnancy but it's largely down to your pregnancy hormones and your expanding womb pressing on your stomach.
Hormones:
It will come as no surprise that your hormones change when you're pregnant. As they slow your digestive system, it can affect how well you digest food, leaving you feeling bloated, and causing indigestion, heartburn and constipation in pregnancy.
The progesterone hormone can also cause the muscles in the oesophagus to relax which can let acid move back out of the stomach.
Your growing uterus:
As your baby and your uterus grow, the pressure on your stomach can cause the stomach acids to head up into your oesophagus. This is why heartburn symptoms are often worse in the third trimester.
Can I take medication for heartburn in pregnancy?
While you can take medication for pregnancy heartburn, there are many ways you can either prevent it or ease the symptoms. If you do feel you need to take medication, speak to your midwife or GP before taking any over-the-counter antacids. If you are taking antacids while pregnant, don't take them within 2 hours of taking folic acid or iron supplements as they can stop these supplements from being absorbed fully.
How can I relieve heartburn during pregnancy?
Switch to five or six small meals a day
Dr Áine O'Connor, a nutrition scientist from the British Nutrition Foundation, recommends little and often to beat the burning sensation that can come after overindulging. 'To avoid heartburn in pregnancy, try eating small regular meals and snacks and avoid large meals.' It is a myth you need to eat for two, so don’t go mad and eat a lot more than you normally would.
Avoid spicy, fatty and fried foods
A common pregnancy food aversion is spicy food and this is probably for the best. Eating lots of spicy, fatty or rich food can make indigestion worse. Raw onions can also cause heartburn.
Be careful of what and when you drink
It's best to avoid citrus fruits and juices, fizzy drinks and cut down on caffeine to prevent heartburn in pregnancy. You should also avoid drinking when you're eating and instead drink in between meals. As Rachel Fitz-D explains "Do NOT glug down gallons of water because, although this will certainly dilute the acid and potentially reduce the burning sensation, it also makes food sloppier and more easy to bubble back up through the hormonally-loosened oesophagus."
Some women swear by drinking a glass of milk to help heartburn in pregnancy. Yoghurt and ice-cream may have a similar ‘cooling’ effect. However, some women find dairy products make their symptoms worse.
Keep a food diary
With that in mind, it's a good idea to track what might be causing your symptoms. 'Keep a note of foods that trigger heartburn and try to avoid them,' says Dr O’Connor. The causes of indigestion can differ widely from woman to woman. For some, fizzy or caffeinated drinks may be the cause. For others, it is fruit juice or tomato-based sauces. By working out what foods cause your indigestion, you can reduce your chances of it happening. But Dr O’Connor adds, be careful you don’t cut out whole food groups which can provide vital nutrients for baby.
Don’t eat late at night
When you lie down, it's easier for stomach contents to rise up and cause you grief. Eating late at night will mean little time for your body to digest what’s in there before you try and get some rest. Try to wait at least 2-3 hours before lying down after eating. If you do get hungry before bed, try to eat something small and plain as a snack.
Similarly, Rachel Fitz-D also suggests eating at the table rather than on the sofa. "Sit at the table to eat rather than having TV suppers. Sitting up straight helps food to go down and stay down!"
Use a pregnancy pillow:
Using a pregnancy pillow can help with pregnancy heartburn relief at night as it's best to sleep with your head and shoulders raised slightly. There's a wide range of pregnancy pillows of different shapes and styles, some of which are better for easing heartburn than others.
Sleep on your left-hand side:
Rachel Fitz-D's top tip for night is to try and sleep on your left, which can also be helped by using a pregnancy pillow. "This is because the stomach is shaped in such a way that lying on the left side encourages stomach contents to stay down, whilst lying on the right side makes it easier for them to come up and cause heartburn.
When to speak to your doctor about heartburn
While heartburn is an uncomfortable complaint, it should go away when you've given birth and your hormones and body start to return to normal. However, if you can't manage your symptoms by making lifestyle or diet changes, speak to your midwife or GP.
You should also seek medical help if your heartburn is accompanied by high blood pressure, headaches, blurred vision, pain below the ribs or swelling as these can be symptoms of pre-eclampsia.
The NHS also suggests contacting your doctor if your heartburn is accompanied by:
• trouble swallowing
• a hoarse voice
• a cough that does not get better or keeps returning
• swollen glands on your neck
• weight loss
• pain or swelling in your stomach
Heartburn in pregnancy: the takeaways
The main thing to remember if you're suffering from heartburn related to pregnancy, is that you're not alone and there are ways to ease it. Unfortunately, it is a common complaint thanks to your changing hormones and body but by being conscious of what you're eating and when, you should be able to relieve heartburn during pregnancy. While it isn't pleasant, it won't be forever and should improve when your baby is born.
As Midwife Pip reassures us, "heartburn is uncomfortable for you but it doesn’t affect your baby directly. Your baby is safely cushioned in your womb (uterus), surrounded by amniotic fluid, and has no contact with your digestive system. Even if you feel nauseous or have heartburn, your body is still absorbing nutrients from food. As long as you're eating reasonably well and staying hydrated, your baby will get what they need."
Heartburn in Pregnancy FAQs
Can I take Gaviscon during pregnancy?
While Gaviscon is safe during pregnancy, the NHS recommends trying to relieve symptoms without medicine if possible. If this isn't possible, speak to your midwife or GP about what medicines may be best for you.
When does heartburn start in pregnancy?
You can get heartburn at any point in your pregnancy but it's more common from 12 weeks onwards and particularly in the third trimester when the baby is taking up more space and your uterus is pressing on your stomach.
About the expert
Rachel Fitz-D is an active birth teacher, parenting consultant and author of Baby Skin To Skin, with over 30 years working as a midwife and as a parenting consultant. Based in Berkshire, near London, she has appeared on numerous radio programmes, talking about various issues from infant feeding to smacking to humanist parenting. She co-created Henley Birthcare, a unique freelance midwifery and doula service offering bespoke care.
About the author
Lorna White is the Products Editor for Mother&Baby. After running the Yours magazine website, specialising in content about caring for kids and grandchildren, Lorna brought her expertise to Mother&Baby in 2020. She has a keen interest in a range of topics from potty training and nutrition to baby names and early development and has a wide range of experienced medical experts and professionals at her fingertips. In her spare time, she enjoys spending time with her two young sisters, dog walking and enjoying the outdoors with her family.