Heartburn During Pregnancy and What to Do About It

The following is a sponsored post by Nightfood. 

While pregnancy is a time of wonder and excitement, it can also pose some challenges and discomforts. Heartburn is a common complaint in the general population that increases during pregnancy, with as many as 50-75% of women experiencing “the burn” at some point in their pregnancy. Often occurring as early as the second month, heartburn can be one of the first signs of pregnancy and is most likely a result of changing hormones.  In preparation for pregnancy, the hormones, progesterone and relaxin, are released to relax smooth muscle tissues in the body, including the GI tract. This helps slow down digestion and increase the absorption of nutrients into the bloodstream and placenta that is essential for mom and her growing baby. The downside of this slowdown, however, is that food stays in the digestive tract for a longer period of time causing such issues as nausea, bloating, gas, and yes, the burn!  

What is heartburn and how do I know if I have it?

That burning sensation that you may feel near your heart is actually happening in the digestive tract and originates where the stomach and esophagus meet in a ring-like muscle called a sphincter. This sphincter, like other smooth muscles, relaxes in pregnancy and allows stomach acid to back up into the esophagus, irritating the lining. Thus, it is the slow metabolism, relaxed sphincter and when the pregnancy progresses, pressure of the growing uterus on gastric contents that worsen heartburn. When heartburn becomes chronic it is referred to as gastroesophageal reflux disorder (GERD).

Heartburn can last several minutes to hours and may also make you experience:

• burning in the throat and mouth
• bloatedness
• belching
• sour taste in the mouth
• sore throat
• frequent coughing
• shortness of breath

What are some lifestyle changes I can make to lessen and possibly, prevent heartburn?

Fortunately, there are many things we can do to lower the likelihood and over time, even prevent heartburn during pregnancy. Perhaps most importantly, eat a sensible and healthy diet that is high in nutrition-dense foods, containing appropriate calories and maco- and micro nutrients for you and your growing baby, drink plenty of water and avoid empty calories and processed foods. Also, find the foods that are triggering your heartburn and avoid them!

While each woman is individual, some common offenders are:

• alcohol
• caffeine
• chocolate
• tomatoes and tomato based foods
• citrus fruits and products
• caffeinated beverages
• spicy foods
• fats and fatty or fried foods
• peppermint
• processed meats
• tobacco and smoke

Other strategies include:

1. Drink fluids between meals- fluid intake during meals tends to distend the stomach. Make sure you have adequate water intake and use “basic” drops to lower the acidity (increase the pH).
2. Eat your final meal earlier in the evening, at least ~3 hours before bedtime. You don’t want your stomach to be digesting dinner around the time you lie down to sleep.
3. If you are struggling with cravings or do need a snack between dinner and bed, try to avoid spicy and/or high-fat options.  I recommend Nightfood ice cream for my patients…it’s the official ice cream of the American Pregnancy Association, and has ingredients to cause less heartburn compared to other ice creams and other snack choices.
4. Eat smaller and more frequent meals to lower the burden of digestion. Again, choosing healthier meals and snacks is a plus!
5. Chew slowly and for longer that will lessen the work of your belly and begin the digestion process. Eating fast not only makes digestion harder for the stomach, increasing acid but also makes you swallow air that can cause more bloating and gas.
6. Occasional antacids may give you immediate relief by quelling the acid through buffering. However, it is important to check with your doctor when taking an antacid since some antacids can increase swelling (e.g., sodium bicarbonate) and others containing aspirin or magnesium trisilicate may be toxic to your baby.
7. Wear loose, comfortable fitting clothing that will allow your tummy to breathe and digest, in peace.
8. Lower your stress by meditation, doing light exercise and stretching, finding connection and spirituality. It will unburden your heart, soul, mind AND body. Avoid exercises that work against gravity (e.g., headstands, downdog) or add pressure to the torso (e.g., high impact aerobics, weight lifting).
9. Elevate the head of your bed at least 6 inches to sleep. By propping yourself up with pillows or wedges under your shoulders or blocks under the feet of your bed, you allow gravity to work for you.
10.  Keep a healthy weight during pregnancy (shoot for 25-35 lbs for single babies) since extra weight will place pressure on your stomach and esophagus. 

Herbal Remedies

• Aloe Vera aids in healing and can help “cool” the digestive tract.
• Herbal teas such as chamomile, fennel, ginger, marshmallow root and papaya can all aid in proper digestion and buffer the acidity.
• Vegetable broths can also aid in buffering the acidity.
• Deglycyrrhizinated licorice (DGL) can treat heartburn and ulcers. Do NOT use if you have or tend to have high blood pressure.

What to do if I suspect I have GERD?

It is important to contact your doctor and nurse to discuss all symptoms you are having including heartburn, at every visit and if warranted, to call the office if symptoms arise that are concerning or are not going away in 1-2 weeks. Discuss your medications with your doctor since some medications can cause heartburn.

After careful consultation with your doctor, you may be recommended to take an over the counter (OTC) antacid or a proton pump inhibitor (PPI) that contains an antacid plus an acid suppressing drug. Other tests may be needed to rule out other medical conditions but the first step is always to talk to your doctor.

Bottom line: there are many things you can do to either cool the “sizzle” or maybe even prevent heartburn from coming back again. So take heart… and not heartburn.

Dr. Lauren Broch holds a Master of Science degree in Human Nutrition, and a Doctorate in Psychology with specialized training in sleep disorders. She served nine years as Director of Education and Training at the Sleep-Wake Disorders Center at Weill Cornell Medical College, and is currently on staff at the Northwell Health Sleep Disorders Center, and is a member of the Scientific Advisory Board for Nightfood.