When you're pregnant, your body undergoes lots of changes to grow a healthy baby. One of the unfortunate side effects can be heartburn. If you know what might be causing your heartburn and ways you can help stop it, you may find some relief.
Heartburn actually has nothing to do with your heart, but is a burning pain in the chest. It happens when the acid from your stomach backs up into your esophagus—the tube that carries food from your mouth to your stomach. Heartburn can affect anyone, but heartburn during pregnancy is especially common. "Eighty percent of women will experience heartburn at some point in their pregnancy," says Erin Bassett-Novoa, M.D., a family doctor in Lawrence, Mass., who provides prenatal and obstetric care. Heartburn happens during pregnancy because of the increasing size of the uterus and a surge in hormones, including progesterone. "The uterus pushes up, increasing pressure on the stomach," says Bassett-Novoa. The bigger Baby gets, the more pressure is exerted on the stomach, which is why most women experience the worst heartburn in the second and third trimesters. In one study of more than 600 pregnant women, 72 percent experienced heartburn in the third trimester.
Progesterone relaxes the smooth muscle tissue of the digestive tract. "The sphincter (or valve) between your stomach and esophagus relaxes, making it easier for stomach acid to work its way backward in the system," says Molly Warner, M.S., R.D.N., a dietitian at Upham's Corner Community Health Center in Boston. "Hormonal changes also slow down the movement of food through the esophagus and stomach," adds Bassett-Novoa.
How to Relieve Heartburn
The good news is that you can prevent and relieve heartburn through dietary changes. "The first step to combat symptoms is to switch from three large meals to four or five smaller meals and to cut out fatty, acidic and spicy foods," says Bassett-Novoa. "You can also make sure not to eat 1-2 hours before bed and avoid lying down after eating."
Specific foods also may contribute to heartburn. "It's important to identify what triggers your heartburn, as each person may have different trigger foods," says Warner. Common causes include "acidic foods including tomato-based products, vinegar (pickles, pepperoncini and some dressings), spicy foods, high-fat foods, caffeine and carbonated beverages," she says. If you aren't sure which foods trigger your heartburn, keep a food diary of what you ate, when you ate it and any symptoms you had afterward.
Foods to Limit
Heartburn is caused by acid going from the stomach back into the esophagus, so eating acidic foods only exacerbates the problem. Limit canned tomatoes and tomato sauces, vinegar, acidic dressings and citrus fruits.
"Foods that are high in fat may delay emptying of the stomach further, as these types of foods require more time to break down," says Crystal Karges, M.S., R.D.N., a San Diego-based dietitian and lactation consultant. As delicious as a greasy burger or bowl of ice cream might be, the aftermath might not be as fun. If you notice that fatty foods trigger your heartburn, eat them infrequently and serve up small portions.
"Spicy foods, citrus and carbonated beverages may cause irritation to the lining of the stomach and can potentially relax the lower esophageal sphincter, which can increase heartburn," says Karges. Spicy foods are often paired up with a heavy fat, like in a coconut curry, or with an acid, like in a spicy marinara sauce, which can further worsen the burn. Onions, garlic and black pepper are a few spicy offenders.
Both caffeinated and decaffeinated coffee can exacerbate heartburn due to decreasing the pressure on the lower esophageal sphincter. Coffee is also a highly acidic beverage.
Foods to Eat More Often
Pictured Recipe: Soothing Ginger-Lemon Tea
Managing heartburn is usually about eliminating foods from your diet, but there are actually some foods you can try eating to minimize the burn. "Vegetables, ginger (which has natural anti-inflammatory properties), whole grains (like oatmeal, rice and breads) and healthy fats may help manage symptoms of heartburn during pregnancy," says Karges. "Higher-fiber foods, like whole grains and vegetables, can help absorb stomach acid and reduce symptoms of heartburn." Bassett-Novoa also recommends ginger, which helps with nausea and vomiting too. Just be sure you're consuming real ginger, and not ginger ale, made without real ginger. Some women like homemade ginger tea, ginger added to soups or stir-fries or gingery candies.
• Whole Grains
• Healthy Fats
Related: Healthy Ginger Recipes
When to Call Your Doctor
If you find no relief after nixing trigger foods, switching up the timing of meals and trying natural remedies, call your doctor, who can prescribe you medicine for some relief. Bassett-Novoa recommends antacids, such as Tums, as the first step. "If those don't work, medications can be prescribed," she said. As always, check with your doctor before taking any medications (even over-the-counter meds) while pregnant.