Heartburn During Pregnancy: What Helps and What to Avoid

Heartburn during pregnancy is common and can be very uncomfortable. It may feel like a burning sensation in the chest or throat, sour fluid coming up, burping, bloating, nausea or discomfort after meals. Some pregnant women feel it after eating, while others notice it more when lying down at night.

Although heartburn is usually not dangerous, it can affect sleep, appetite and daily comfort. The good news is that many pregnant women feel better with simple changes such as smaller meals, avoiding trigger foods, not lying down soon after eating and sleeping slightly propped up.

ACOG explains that acid reflux happens when the muscle between the oesophagus and stomach does not work properly, allowing food and digestive fluids to move back up. This can cause a burning feeling in the chest and throat, known as heartburn. [1]

Why Does Heartburn Happen During Pregnancy?

1. Hormonal changes

Pregnancy hormones can relax smooth muscles in the body, including the valve between the stomach and oesophagus. When this valve relaxes, stomach acid can move back up more easily, causing reflux and heartburn.

2. Pressure from the growing uterus

As the baby grows, the uterus takes up more space and can press on the stomach. This may push stomach contents upward, especially after large meals or when lying down.

3. Slower digestion

Pregnancy can slow digestion. Food may stay in the stomach longer, increasing the chance of bloating, indigestion and reflux.

4. Trigger foods and drinks

Some foods and drinks can worsen heartburn. Common triggers include spicy food, oily or fried food, acidic food, chocolate, coffee, tea, carbonated drinks and large meals. However, triggers vary from person to person.

What Does Pregnancy Heartburn Feel Like?

Pregnancy heartburn may cause:

• A burning feeling in the chest
• A burning feeling in the throat
• Sour or bitter taste in the mouth
• Burping or bloating
• Feeling very full after meals
• Nausea after eating
• Worse symptoms when lying down
• Cough or throat irritation from reflux

Heartburn can feel frightening if it causes chest discomfort. If you are unsure whether the pain is heartburn or something more serious, seek medical advice.

What Helps Heartburn During Pregnancy?

1. Eat smaller, more frequent meals

Large meals can stretch the stomach and increase reflux. Try eating smaller meals more often instead of three large meals. NHS guidance says changes to diet and lifestyle may be enough to control mild indigestion and heartburn in pregnancy, including eating smaller meals more often. [2]

2. Avoid lying down soon after eating

Lying down too soon after meals makes it easier for acid to move back up. Try to stay upright after eating, especially after dinner.

HealthHub Singapore advises pregnant women with heartburn to avoid eating a few hours before bedtime and to prop themselves up with pillows while sleeping. [3]

3. Identify your trigger foods

Not every pregnant woman has the same triggers. Keep a simple food and symptom diary for a few days. Write down what you ate, when symptoms started and how severe they were.

Common triggers include:

• Spicy food
• Oily or fried food
• Tomato-based food
• Citrus fruits or juices
• Chocolate
• Peppermint
• Coffee and tea
• Carbonated drinks
• Very large meals

4. Drink fluids between meals

Drinking a lot during meals can make the stomach feel too full. Try sipping fluids between meals instead. Do not reduce fluids too much, especially in Singapore’s warm weather.

5. Sleep slightly propped up

If heartburn is worse at night, raise your upper body slightly with pillows or a wedge pillow. Some women find it helpful to sleep on their side.

NUHS guidance for reflux recommends avoiding eating within 2 to 3 hours before bedtime, avoiding lying down after meals and raising the head of the bed for night-time symptoms. [4]

6. Wear loose, comfortable clothing

Tight clothing around the waist and abdomen may add pressure to the stomach. Choose comfortable maternity clothing that does not squeeze your belly.

7. Try milk or yoghurt if it suits you

Some women find that milk or yoghurt temporarily eases heartburn. HealthHub Singapore suggests drinking a glass of milk to ease heartburn. [3]

However, this does not work for everyone. If full-cream milk worsens symptoms, try smaller amounts, low-fat milk or another option your doctor recommends.

8. Chew slowly and eat calmly

Eating quickly can make you swallow more air and feel bloated. Slow eating may reduce fullness and discomfort after meals.

What Should Pregnant Women Avoid?

• Avoid lying down immediately after meals.
• Avoid large, heavy meals, especially at night.
• Avoid foods that clearly trigger your symptoms.
• Avoid tight waistbands or clothing that presses on your belly.
• Avoid smoking and alcohol. These are not safe in pregnancy and can worsen reflux.
• Avoid self-medicating with heartburn medicine without checking with your doctor or pharmacist.
• Avoid taking antacids too close to iron or folic acid supplements unless advised.

Can Pregnant Women Take Antacids?

Some antacids and alginates may be used during pregnancy, but it is best to check with your doctor, gynae or pharmacist before taking any medicine. This is especially important if you have kidney disease, high blood pressure, are taking iron supplements, or are already taking other medications.

NHS guidance says pregnant women may only need antacids and alginates when symptoms occur, but a doctor may recommend taking them before symptoms come on, such as before a meal or before bed. NHS also advises not taking antacids within 2 hours of folic acid or iron supplements because antacids can affect absorption. [2]

If antacids and alginates do not improve symptoms, your doctor may prescribe another medicine to reduce stomach acid. Do not start stronger acid-reducing medicine on your own.

What Are Alginates?

Alginates are medicines that form a protective layer on top of stomach contents. This may help reduce reflux after meals. HealthHub Singapore lists sodium alginate as a medicine used to treat heartburn and acid reflux. [5]

Ask your doctor or pharmacist whether an alginate is suitable for you during pregnancy and how to take it safely.

When Should You Speak to Your Doctor?

Speak to your doctor, gynae or pharmacist if:

• Heartburn happens often or affects sleep
• Symptoms do not improve with diet and lifestyle changes
• You need medicine frequently
• You are vomiting often
• You have difficulty swallowing
• You are losing weight or cannot eat properly
• You have severe upper abdominal pain
• You are unsure whether your chest pain is heartburn
• You are taking iron, folic acid, calcium or other supplements and need advice on timing

Seek Urgent Medical Help If You Have These Symptoms

Not all chest or upper abdominal pain is heartburn. Seek urgent medical help if you have:

• Severe chest pain
• Chest pain with shortness of breath, sweating, dizziness or fainting
• Severe headache or blurred vision
• Sudden swelling of the face or hands
• Severe upper right abdominal pain
• Vomiting blood or black stools
• Severe persistent vomiting
• Reduced baby movements in later pregnancy

Severe upper abdominal pain, headache, visual symptoms or sudden swelling during pregnancy should be checked promptly because they may be related to conditions other than heartburn.

Singapore-Friendly Meal Tips for Pregnancy Heartburn

You do not need to avoid all local food. Instead, notice your personal triggers and adjust portion size, timing and cooking style.

Possible gentler options

• Fish soup with rice or bee hoon, less oily soup
• Plain porridge with egg, fish, tofu or minced meat
• Yong tau foo with more vegetables and fewer fried items
• Economic rice with less gravy, less chilli and less fried food
• Wholemeal bread with egg or cheese
• Oats with banana or yoghurt

Foods that may trigger symptoms in some women

• Very spicy laksa, curry or chilli-heavy dishes
• Deep-fried snacks
• Large portions of fried noodles or oily rice
• Tomato-based sauces
• Carbonated drinks
• Large milk tea, coffee or tea late in the day

Triggers are individual. If a food does not cause symptoms for you and is otherwise pregnancy-safe, you may not need to avoid it completely.

Simple Daily Plan to Reduce Heartburn

Morning

• Eat a small breakfast instead of skipping meals.
• Limit coffee or tea if they trigger reflux.
• Drink water gradually instead of drinking a large amount at once.

Afternoon

• Choose a balanced lunch with protein, vegetables and a moderate carbohydrate portion.
• Take a short walk after meals if comfortable.
• Avoid lying down immediately after eating.

Evening

• Eat dinner earlier if possible.
• Keep dinner smaller and less oily.
• Avoid late-night heavy snacks.
• Sleep slightly propped up if reflux is worse at night.

FAQ: Heartburn During Pregnancy

Is heartburn common during pregnancy?

Yes. Heartburn is common during pregnancy because hormones can relax the valve between the stomach and oesophagus, and the growing uterus can put pressure on the stomach.

What helps heartburn during pregnancy?

Smaller meals, avoiding trigger foods, staying upright after meals, avoiding late-night eating, sleeping slightly propped up, wearing loose clothing and asking a doctor or pharmacist about suitable antacids or alginates may help.

What foods should I avoid for pregnancy heartburn?

Common triggers include spicy food, oily or fried food, acidic food, chocolate, coffee, tea, carbonated drinks and large meals. Triggers vary, so keeping a food diary may help.

Can I take antacids while pregnant?

Some antacids and alginates may be used during pregnancy, but pregnant women should check with a doctor, gynae or pharmacist before taking medicine. Antacids should not be taken within 2 hours of iron or folic acid supplements unless advised.

Does milk help pregnancy heartburn?

Milk may temporarily ease heartburn for some women, and HealthHub Singapore suggests drinking a glass of milk to ease symptoms. However, it may not help everyone, and some women may find certain dairy products worsen symptoms.

When should I worry about heartburn during pregnancy?

Seek medical advice if heartburn is severe, frequent, affects eating or sleep, does not improve with lifestyle changes, or comes with vomiting, difficulty swallowing, weight loss, severe chest pain or severe upper abdominal pain.

Can heartburn hurt my baby?

Simple heartburn usually does not harm the baby, but severe vomiting, poor intake or symptoms that may not be heartburn should be assessed by a doctor.

Key Takeaway

Heartburn during pregnancy is common and is often caused by hormonal changes, slower digestion and pressure from the growing uterus. It can often be managed with smaller meals, avoiding personal trigger foods, staying upright after eating, avoiding meals close to bedtime and sleeping slightly propped up.

If symptoms are frequent, severe or affecting sleep and eating, speak to your doctor, gynae or pharmacist. Some medicines may be suitable during pregnancy, but it is best to get professional advice, especially if you are also taking iron, folic acid or other supplements.

References

• [1] American College of Obstetricians and Gynecologists, Problems of the Digestive System.
• [2] NHS, Indigestion and Heartburn in Pregnancy.
• [3] HealthHub Singapore, Pregnancy A-Z of Pregnancy Health.
• [4] National University Health System Singapore, Gastroesophageal Reflux Disease.
• [5] HealthHub Singapore, Sodium Alginate.
• [6] SingHealth, Coping with Common Symptoms in Pregnancy.