Heartburn and acid reflux can occur at any point during pregnancy with varying triggers depending on which trimester you are in.
In the beginning of pregnancy, nausea and morning sickness can relate to hormone imbalances, whereas in the second and third trimester it may relate to baby pressing on your diaphragm. Other factors include dehydration and/or lack of nutrients especially protein.
Pregnancy itself predisposes you to heartburn and reflux for several reasons that you can’t control:
Your ever-growing baby is pushing up on your stomach which increases intra-abdominal pressure Your stomach is naturally more acidic from placental production of gastrin, a hormone that tells the stomach to pump out hydrochloric acid (stomach acid) The hormone progesterone increases, which relaxes the lower esophageal sphincter, causing stomach acid to more easily flow back into your esophagus Your intestines have slower motility due to higher progesterone (this maximizes nutrient extraction from the food you eat) and from being cramped by your baby
Pregnancy itself predisposes you to heartburn and reflux for several reasons that you can’t control:
Your ever-growing baby is pushing up on your stomach which increases intra-abdominal pressure Your stomach is naturally more acidic from placental production of gastrin, a hormone that tells the stomach to pump out hydrochloric acid (stomach acid) The hormone progesterone increases, which relaxes the lower esophageal sphincter, causing stomach acid to more easily flow back into your esophagus Your intestines have slower motility due to higher progesterone (this maximizes nutrient extraction from the food you eat) and from being cramped by your baby
Why Antacids Aren’t the Best Option for Pregnancy Heartburn
While you may be tempted to just pop an antacid, it may be a better option to avoid them completely. The acid in your stomach is actually good and necessary for several important reasons:
To kill harmful bacteria, viruses and fungi To help you absorb minerals (like iron, calcium, magnesium, zinc, copper, etc.) To digest protein To enhance vitamin B12 absorption
As you can see, stomach acid is there for a reason. If you took an antacid, this would decrease the acid in your stomach, which would actually increase your chances of getting food poisoning, having digestive problems, and may potentially lead to nutrient deficiencies. Plus, most heartburn is actually a result of too little acid, not too much.
Also, some over-the-counter antacids contain aluminum, which is a known neurotoxin that may be harmful to you and your baby. As one researcher puts it, “Over-the-counter antacids are the most important source for human aluminum exposure from a quantitative point of view. However, aluminum can act as a powerful neurological toxicant and provoke embryonic and fetal toxic effects in animals and humans after gestational exposure.”
To summarize, try the following if you’re experiencing heartburn:
Avoid taking antacids (and consider the possibility of your acid levels being too low). Avoid eating large portions at meals (practice mindful eating) and opt for smaller, more frequent ones. Sip on liquids throughout the day and avoid drinking during meals. Be mindful of your intake of carbohydrates, especially sugar and refined (processed) carbs, to avoid blood sugar spikes. For nighttime heartburn, eat an earlier, smaller dinner and elevate the head of your bed. Keep a detailed food diary to help identify your trigger foods. Consider probiotics, fermented foods, or digestive enzymes. Try acupressure or acupuncture. Consult your qualified naturopath for safe options to relieve stubborn heartburn.
Never discount the importance of preparing your body before you fall pregnant, as this can also prevent heartburn due to nutrient and hormonal imbalances. You’ll find more information in my book.
Hopefully the tips in this article help you get some relief, or at the very least provide you with some reassurance. Has anything in particular helped you manage your heartburn during pregnancy? If so, feel free to share what has worked for you in the comments section! Your tip just might help someone else.
References Richter, Joel E. “Gastroesophageal reflux disease during pregnancy.” Gastroenterology Clinics 32.1 (2003): 235-261.
Phupong, Vorapong, et al. “Interventions for heartburn in pregnancy.” The Cochrane Library (2015).
Tan, Eng Kien, and Eng Loy Tan. “Alterations in physiology and anatomy during pregnancy.” Best Practice & Research Clinical Obstetrics & Gynaecology 27.6 (2013): 791-802.
Reinke, Claudia M., Jörg Breitkreutz, and Hans Leuenberger. “Aluminium in over-the-counter drugs.” Drug Safety 26.14 (2003): 1011-1025.
Domingo, José L. “Aluminum.” Reproductive and Developmental Toxicology. Academic Press, (2011): 407-413.
Ma, Rui, et al. “Early-life exposure to aluminum and fine motor performance in infants: a longitudinal study.” Journal of Exposure Science & Environmental Epidemiology 31.2 (2021): 248-256.
Wu, Keng Liang, et al. “Effect of liquid meals with different volumes on gastroesophageal reflux disease.” Journal of Gastroenterology and Hepatology 29.3 (2014): 469-473.
Zhang, Qing, et al. “Effect of hyperglycemia on triggering of transient lower esophageal sphincter relaxations.” American Journal of Physiology-Gastrointestinal and Liver Physiology 286.5 (2004): G797-G803.
Austin, Gregory L., et al. “A very low-carbohydrate diet improves gastroesophageal reflux and its symptoms.” Digestive Diseases and Sciences 51.8 (2006): 1307-1312.
Altomare, Annamaria, et al. “Gastroesophageal reflux disease: Update on inflammation and symptom perception.” World J Gastroenterol 19.39 (2013): 6523-8.
Zou, Duowu, et al. “Inhibition of transient lower esophageal sphincter relaxations by electrical acupoint stimulation.” American Journal of Physiology-Gastrointestinal and Liver Physiology 289.2 (2005): G197-G201.
