Acidity and heartburn in pregnancy: symptoms, causes and remedies

Heartburn is a common ailment in pregnancy, especially in the third trimester. In this article, we’ll tell you everything a mom-to-be should know about this annoying ailment.

Heartburn , which in medicine takes the name of ” heartburn “, is a very common disorder in pregnancy and affects from 17% to 45% of expectant mothers .

It usually manifests itself as a burning sensation or pain in the pit of the stomach , which tends to appear mainly in the third trimester , although it can sometimes be present from the very beginning of pregnancy . 

While heartburn can be very uncomfortable, it’s not dangerous to your baby’s health and tends to go away after delivery . In the presence of excessive weight gain , however, it may regress more slowly.

Symptoms of heartburn in pregnancy

This disorder typically manifests itself as a burning or pain in the center of the chest , just behind the breastbone, which appears mainly when lying down or after meals and which can last from a few minutes to several hours

Other symptoms can be:

• burning in the throat
• bad taste in the mouth or a feeling of  hot, sour or bitter liquid in the back of the throat
• feeling of heaviness in the stomach or bloating
• nausea
• stomach cramps
• belching
• chronic cough
• hoarseness
• wheezing or other asthma-like symptoms
• hiccup

The causes of heartburn in pregnancy

In most cases, heartburn in pregnancy is caused by acidity , which in turn depends on several factors.

In the first months of pregnancy , it would seem linked above all to the increase in progesterone : this hormone, in fact, relaxes the muscles of the uterus to favor the development of the embryo, but at the same time reduces the muscle tone of the digestive organs and of the cardia , i.e. the valve that prevents the acid contents of the stomach from escaping.

The effect is the so-called gastroesophageal reflux , i.e. the ascent of gastric juices into the esophagus (the channel that connects the stomach to the mouth), which causes irritation and burning .

Added to this, especially in the third trimester , is the growth of the child and the consequent enlargement of the uterus , which “steals space” from nearby organs. As a result, the intestines and stomach are compressed and their emptying slows down, favoring the onset of reflux.

In addition, heartburn may be caused or made worse by :

• incorrect eating habits
• obesity
• some drugs
• stress

How to prevent heartburn in pregnancy?

To prevent the onset of heartburn and acid reflux, a few simple strategies can help . Let’s see them together.

1. Eat small and frequent meals:  in order not to overload the stomach, it is important to avoid overeating . At the same time, however, too long a fast can also cause stomach pain and nausea . For this reason, during pregnancy, it is usually recommended to have 5 meals a day , three main ones plus two snacks.

2. Avoid irritating foods and drinks: the consumption of particularly acidic, spicy or fat-rich foods , as well as caffeine and carbonated drinks , increases stomach acidity. So no more fried foods, citrus fruits, tomatoes, mint and chocolate , but also onions , peppers , beans and peas . If the reflux is already present, it is better to prefer cold or warm dishes : the heat, in fact, accentuates the burning.

3. Increase your intake of vitamins B1 and B2: Foods rich in these micronutrients, such as buckwheat , eggs, fresh pineapple and hazelnuts , can help keep acidity in check.

4. Chew slowly: this simple trick helps improve digestion .

5. Drink abundantly between meals:  limiting the amount of liquids at lunch and dinner helps prevent excessive filling of the stomach and reduce heartburn.

6. Pay attention to your posture: keeping your torso upright, especially during meals, will reduce the pressure on your stomach.

7. Do not lie down immediately after eating: to reduce the risk of acid reflux, after meals it would be good to wait at least two or three hours before going to bed .

8. Sleeping with the head raised about 15-20 cm : this position helps to counteract the ascent of gastric juices. The simplest strategy is to place  an extra pillow under your head . Alternatively, you can insert shims under the legs of the bed or buy a special wedge cushion to place between the mattress and the base.

9. Wear loose , comfortable clothing : Clothing that is too tight can contribute to constriction of the stomach .

10. Practice moderate physical exercise: a 10-15 minute walk after meals can be a panacea for digestion. Motor activity is also an excellent ally to fight stress.

11. Don’t smoke : There are countless  reasons not to smoke while pregnant and heartburn is just one of them. The chemicals contained in cigarettes further relax the heart and promote the return of stomach acids .

12. Avoid alcohol : like smoking, alcohol is also absolutely not recommended during pregnancy . In addition to the risk of causing various problems for the developing baby (from low birth weight to learning disabilities ), alcohol also irritates the stomach and contributes to gastroesophageal reflux .

Natural remedies for acidity heartburn in pregnancy

Given that in case of severe heartburn it is always important to notify the doctor , there are some natural remedies that can help relieve this ailment.

In particular, it can be of great help to consume certain foods capable of counteracting acidity , such as  warm milk or yoghurt , preferably skimmed because they are less rich in fat.

Ginger , both fresh and powdered, can also be effective at fighting acidity. However, the  Guide to Physiological Pregnancy  of the Ministry of Health advises against taking it during pregnancy, because there is no data on the maximum amount that can be taken without risk to the fetus .

Finally, another very useful natural remedy against heartburn is represented by extracts and herbal teas based on:

• chamomile
• fennel seeds
• mauve
• melissa
• linden
• aloe

Conversely, to combat stomach acid during pregnancy, it would be better to avoid using baking soda . In fact, remember that a pregnant woman should limit the intake of sodium , due to its negative effects on water retention and blood pressure .

Heartburn and acidity medications in pregnancy

When natural remedies don’t work and heartburn is intense , you need to contact your trusted doctor , who will investigate the possible causes and recommend the possible intake of medicines compatible with pregnancy .

We take this opportunity to remind you once again that a pregnant woman (or who suspects she is) should never resort to the use of medicines without having first consulted the doctor : some products, in fact, even if available without a prescription or belonging to the category of phytotherapeutic or herbal remedies can put the health of mother and child at risk.

Having made this clarification, we can say that according to the indications of the Italian Medicines Agency (AIFA), the first choice products for the treatment of heartburn and associated symptoms are the so-called antacid drugs .

These medicines neutralize the acidity produced by gastric juices and are absolutely safe for mother and child .

However, since they can interfere with the absorption of other medicines , such as iron or folic acid supplements , it is always a good idea to take them at least two hours away from these preparations and in any case according to the doctor’s instructions .

If, on the other hand, antacid therapy is not sufficient to relieve the discomfort, the professional will evaluate whether to prescribe more powerful drugs , which could vary according to the type and intensity of the symptoms .

Acidity and heartburn in pregnancy: when to worry?

In most cases, heartburn does not represent a dangerous disorder for mother and child and tends to resolve spontaneously after childbirth . 

In case of strong symptoms , however, it is always important to contact your trusted doctor or gynecologist , to investigate the causes and immediately start the most suitable treatment.