Heartburn During Pregnancy

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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 up.

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 frequently:

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 clothes:

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 heartburn: 

(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 heartburn:

  • 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:

Antacids

(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 women.
  • 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 this.
 

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 last.

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 (DGL): 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 Seltzer): 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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