Heartburn is common during pregnancy, affecting up to 80% of women in their third trimester. While the symptoms may be frequent and distressing, the good news is that serious complications are rare.
During pregnancy, pressure from the growing womb on the stomach may lead to acid reflux into the oesophagus and, consequently, heartburn. If you’re expecting twins, or even triplets, you’re even more likely to experience heartburn, as there’s added pressure on your stomach.
Progesterone, the “pregnancy hormone” that helps to nurture your growing baby, also tends to relax the lower oesophageal sphincter (LES), the valve-like structure between the stomach and the oesophagus. This may also lead to reflux and heartburn.
Furthermore, an unhealthy lifestyle, inflammation of the stomach lining or oesophagus, as well as overweight may contribute to heartburn. Excess body fat may compress the stomach, leading to heartburn – another reason why it’s important to manage your weight before and during pregnancy.
Antacids may not be safe
If possible, try to avoid using antacids while you’re pregnant. Unfortunately, their safety during pregnancy hasn’t been firmly established.
What’s more, research by the Universities of Edinburgh and Tampere in Finland recently indicated that children born to mothers who take acid-suppressing medication during pregnancy may have a higher risk of developing asthma. Even though more research is needed to confirm this link, it’s another indication that antacids may not be safe.
Experts recommend avoiding antacids that contain sodium bicarbonate during pregnancy, as these may lead to excessive blood alkalinity and fluid overload (oedema).
Simple lifestyle changes may help
If you’re pregnant, heartburn is best managed through simple lifestyle changes. These include eating frequent, small meals, avoiding foods that seem to trigger heartburn, and staying upright for at least three hours after enjoying a meal and before lying down. It may also help to chew gum, as this stimulates the production of saliva, which neutralises stomach acid.
Interestingly, acupuncture may also help. The Cochrane Institute recently examined several research studies and found that women with heartburn who received acupuncture during pregnancy reported improved quality of life. For one, they were able to eat and sleep better.
If simple lifestyle measures don’t work, talk to your doctor. They may prescribe an H2 receptor antagonist or proton pump inhibitor. Alternatively, your doctor may suggest taking a calcium/magnesium-based antacid. These antacids, taken as directed, have the added benefit of increasing calcium supplementation during pregnancy.
Mahan, LK. Escott-Stump, S. Raymond, JL. (2012) Krause’s Food and the Nutrition Care Process - 13th edition. Elsevier. ISBN: 978-1-4377-2233-8.