What causes heartburn in pregnancy?
The top of your stomach has a valve to keep down the food you've swallowed and the stomach acid that digests your food.
The pregnancy hormone progesterone relaxes this valve, meaning stomach acid, and sometimes partially digested food, can squeeze back up into your gullet (oesophagus). You may feel a burning sensation in your chest when this happens. Heartburn
and acid reflux are common in pregnancy.
In early pregnancy
, heartburn or indigestion may make your pregnancy sickness
worse (Chittumma et al 2007, Tiran 2004)
In later pregnancy, your growing baby squashes your stomach, making you more prone to bringing up a little food.
Your heartburn may be worse if:
Tell your midwife or GP if your heartburn doesn't go away. Severe, persistent heartburn can be symptom of pre-eclampsia
, a serious illness of late pregnancyPriority Nursing Diagnosis For Gerd Naturally (⭐️ Heartburn Relief) | Priority Nursing Diagnosis For Gerd Symptomshow to Priority Nursing Diagnosis For Gerd for (NHS 2015a)
How can I prevent heartburn?
It's often simply a case of trial and error to find out which foods affect you most – and then avoiding them.
Eating small meals often, rather than large meals that are hours apart, will prevent your stomach from becoming too full and pushing up under your diaphragm.
Try to eat your main meal
of the day at lunchtime. Eat your evening meal early in the evening, so your body has time to digest it before you go to bed.
Avoid spicy, rich, fatty and fried foods (NHS 2014)
, and anything else that triggers your symptoms (NHS for 1 last update 2020/02/26 2014) (NHS 2014)
. Sugar, tea, and coffee
may also make your heartburn worse.
Some women find that foods containing garlic make their heartburn worse. However, for others, eating a clove or two of raw garlic every day, or using whole cloves in cooking, can actually help.
Or you could take a garlic capsule to relieve the intensity of your symptoms. Garlic capsules should be rich in allicin to be effective. Ask your midwife
before taking any supplements in pregnancy
If you're taking iron tablets
that make your heartburn worsePriority Nursing Diagnosis For Gerd Acid Reflux (🔴 Symptoms) | Priority Nursing Diagnosis For Gerd Chronic Heartburnhow to Priority Nursing Diagnosis For Gerd for (Hyder et al 2002)
, talk to your midwife or doctor about changing to a liquid supplement instead (McKenna the 1 last update 2020/02/26 et al 2003) (McKenna et al 2003)
Drink water between meals rather than with a meal. Drinking while you eat dilutes your digestive juices, meaning they don't work as well to break down food.
Try to cut down on meat and fizzy drinks, if you have them often. Both can cause heartburn (Ramu et al 2011)
. A little lean meat is healthy during pregnancy, but fizzy drinks have no nutritional value.
Try to stay sitting upright after eating, as lying down may cause you to bring up a little food. Raising the head of your bed in late pregnancy may help. Place some sturdy objects, such as bricks or wood, underneath your mattress (NICE 2012)
Heartburn may also be worse if you smoke
. It's another reason to stop, as smoking is harmful to your baby
Which complementary therapies can ease heartburn?
There's mixed evidence about how effective complementary therapies are for treating heartburn. If you want to use a therapist, see one who's registered, insured and experienced in treating pregnant women. Acupuncture and acupressure
These therapies work on the principle that points in your body can be stimulated to improve your symptoms. There's some limited evidence that acupuncture may help with heartburn (Dickman et the 1 last update 2020/02/26 al 2007) (Dickman et al 2007)
However, the use of needles during an acupuncture treatment may release natural painkillers called endorphins in your body. It may be the endorphins that are easing your symptoms (NHS 2015b)
You'll have to pay for an acupuncture session, but you could try acupressure for yourself. Press acupuncture point (pericardium point 6) on your wrist to try to relieve your symptoms.
To locate pericardium point 6:
- Use one hand on the inside of your opposite wrist, measuring up three finger-widths from the crease between your hand and arm.
- At the point where your third finger is, lift the pressure off until you are just touching the skin, and feel lightly for a slight dip. Press into this dip quite deeply and it will feel bruised.
- When your heartburn is severe, press this point on each wrist for between 20 times and 30 times at one-second intervals.
Try adding four drops of lemon, orange or neroli (orange blossom) essential oils
to a teaspoonful of grapeseed base oil. Massage this into your chest and upper back, or put the blend in your bath so you can inhale the vapours. Herbal remedies
Check with your midwife before using herbal teas
as a regular remedy. Peppermint tea may help your digestion. But don't drink other teas that are reputed to aid digestion, such as fennel. Fennel contains chemicals that may make your womb (uterus) contract.
Ginger, camomile and dandelion herbal tea
may help to relieve heartburn, with the following precautions:
- If you've had any bleeding, it's best to drink ginger tea in moderation, as it contains chemicals that can slow down clotting (Zadeh and Kor 2014).
- If you're taking medication for diabetes, don't drink dandelion tea, as it can interfere with your medication (Koren et al 2015).
- If you're suffering from insomnia, drinking a lot of camomile tea may actually make it more difficult to sleep.
Though there's no evidence that homeopathic treatments work, if you want to try them, consult a qualified, registered homeopath. Osteopathy and related therapies
Osteopathy, chiropractic and Alexander Technique are therapies that aim to realign your posture. There's no strong evidence that these therapies will be effective to treat your heartburn (NCOR 2012)
. However, if you don't want to take over-the-counter remedies, and you think these therapies would generally help your posture during pregnancy, they may be worth a try.
Relaxation therapies that focus on posture can also help, for example yoga
, or qi gong. These therapies have other health benefits, such as reducing stressPriority Nursing Diagnosis For Gerd Heartburn Naturally (🔥 Naturally) | Priority Nursing Diagnosis For Gerd 10 Drinkshow to Priority Nursing Diagnosis For Gerd for (Marc et al 2011)
and helping to prepare you emotionally and physically for labour (Smith et al 2011)
Learn about other common complaints in our video on the side effects of pregnancy
References Chittumma P, Kaewkiattikun K, Wiriyasiriwach B. 2007. Comparison of the effectiveness of ginger and vitamin B6 for treatment of nausea and vomiting in early pregnancy: a randomized double-blind controlled trial. J Med Assoc Thai. 90(1): 15-20
Dickman R, Schiff E, Holland A, et al. 2007. Acupuncture vs. doubling the proton pump inhibitor dose in refractory heartburn. Aliment Pharmacol Ther. 26(10):1333-1344
Hyder SM, Persson LA, Chowdhury AM, et al. 2002. Do side-effects reduce compliance to iron supplementation? A study of daily and weekly-dose regimens in pregnancy. J Health Popul Nutr. 20(2):175-9
Koren R, Lerner A, Tirosh A, et al. 2015. The use of complementary and alternative medicine in hospitalized patients with type 2 diabetes mellitus in Israel. J Altern Complement Med. 21(7):395-400
Marc I, Toureche N, Ernst E, et al. 2011. Mind-body interventions during pregnancy for preventing or treating women's anxiety. Cochrane Database of Systematic Reviews. (7): CD007559 www.onlinelibrary.wiley.com [Accessed November 2015]
McKenna D, Spence D, Haggan SE, et al. 2003. A randomized trial investigating an iron-rich natural mineral water as a prophylaxis against iron deficiency in pregnancy Clin. Lab. Haem. 25: 99-103
NCOR. 2012. Osteopathic management of patients during pregnancy – a snapshot summary report. National Council for Osteopathic Research. www.ncor.org.uk [Accessed November 2015]
NHS Choices. 2014. Heartburn and indigestion in pregnancy. Health A-Z. www.nhs.uk [Accessed November 2015]
NHS Choices. 2015a. Pre-eclampsia – symptoms. NHS Choices, Health A-Z. www.nhs.uk [Accessed November 2015]
NHS Choices. 2015b. Acupuncture – evidence, clinical trials. NHS Choices, Health A-Z. www.nhs.uk [Accessed November 2015]
NICE. 2012. Dyspepsia – pregnancy-associated. National Institute for Health and Care Excellence, Clinical Knowledge Summaries. cks.nice.org.uk [Accessed January 2017]
Ramu B, Mohan P, Rajasekaran MS, et al. 2011. Prevalence and risk factors for gastroesophageal reflux in pregnancy. Indian J Gastroenterol. 30(3): 144-7
Smith CA, Levett KM, Collins CT, et al. 2011. Relaxation techniques for pain management in labour. Cochrane Database of Systematic Reviews (12): CD009514. www.onlinelibrary.wiley.com [Accessed November 2015]
Tiran D. 2004. Nausea and vomiting in pregnancy: an integrated approach to care. Edinburgh: Elsevier Science
Zadeh JB and Kor NM. 2014. Physiological and pharmaceutical effects of ginger (Zingiber officinale Roscoe) as a valuable medicinal plant. European Journal of Experimental Biology 4(1):87-90