How to manage pregnancy heartburn (including which foods to avoid)

As though eating during pregnancy wasn’t challenging enough—avoiding foods that aren’t safe, eating enough but not too much and hitting all your nutritional requirements—for many expectant moms, eating also brings on an uncomfortable burning sensation in chest or throat: heartburn.

What causes heartburn during pregnancy?

Hormonal changes in pregnancy cause the valve between your esophagus and stomach to relax, allowing acid to escape up to your throat, explains Amanda Selk, an OB/GYN at Women’s College Hospital in Toronto. "In addition, as the uterus grows, there is more pressure on your stomach, which can also cause the stomach acid to back up," she says.

Pregnant women are also prone to heartburn because their digestive system has slowed down, meaning stuff is sticking around in the stomach longer, explains Heather Martin, an Edmonton-based midwife. "This slowed movement of food means, on top of heartburn, you can get constipation and indigestion." And unfortunately, as the uterus continues to grow and press against the stomach, this triple whammy can intensify.

How can I prevent pregnancy heartburn?

The best course of action is to try to prevent the heartburn from occurring in the first place. So, eat smaller meals and avoid fatty foods, carbonated beverages, caffeine, acidic foods (like tomatoes) and spicy foods. “This will help decrease the amount of acid in your stomach," explains Selk. Citrus fruits like oranges can also bring on the burn, but they offer valuable folic acid, so instead of cutting them out entirely, try a low-acid orange juice and drink it after you've had cereal or toast to help absorb the stomach acid. And during meals, skip beverages—it can decrease the effectiveness of gastric juices, says Martin. In addition to adjusting what you eat, Martin suggests taking a teaspoon of apple cider vinegar diluted in a cup of water once a day to try to increase the effectiveness of your gastric juices. And keep in mind that laying down after eating can make heartburn worse; Martin suggests not eating after 7 p.m., as it might make going to bed uncomfortable. 

How to relieve pregnancy heartburn

When you’re experiencing heartburn, a handful of raw almonds can help you feel better, as can ginger or ginger tea. Also, try snacking on pineapple, which can act as a digestive enzyme. After dinner, we know it's tempting to lie on the couch and watch Netflix, but try going on a walk to ease your heartburn. In terms of medications, it's considered safe to take Tums, Gaviscon or Ranitidine (Zantac), but it's a good idea to talk to your health care provider before taking any medication.

Should I be worried about heartburn during pregnancy?

While heartburn isn’t fun, it generally isn't a serious problem. However, pain in the abdomen or shoulder, which is sometimes mistaken for heartburn, can be a sign of preeclampsia, a pregnancy complication where the woman develops high blood pressure and signs of damage to the liver or kidneys, usually after 20 weeks. "If your heartburn is sudden, doesn't go away, accompanies pain in the abdomen and up the back, and is really intense with severe pain, contact your health care provider or go to the hospital for emergency assessment," says Martin.

Read more: Caffeine during pregnancy: Is if safe? How much water should you drink during pregnancy?