All About Heartburn In Pregnancy

Heartburn in pregnancy

Like most pregnant women, you are probably aware that heartburn is a common occurrence during pregnancy. Perhaps, you already suffer from it yourself. Sometimes, it is unclear whether that burning sensation in the center of the chest is heartburn or not. One thing is clear though. Heartburn has nothing to do with your heart!

How common is heartburn in pregnancy?

Studies have shown that 17% to 49% of all pregnant women will suffer heartburn. It becomes more common as the pregnancy progresses: from 22% in the first trimester to 39% in the second trimester to between 60% and 72% in the third trimester.

What causes heartburn during pregnancy?

Heartburn occurs when the valve between the stomach and the esophagus is unable to prevent stomach acid from passing back into the esophagus (see the image below). During pregnancy, the hormone progesterone causes the valve to relax. This allows stomach acid to pass into the esophagus and irritate the lining.

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Image: webmd

Heartburn and indigestion are more common during the third trimester because the growing uterus puts pressure on the intestines and stomach. The pressure on the stomach may also push contents back up into the esophagus.

What can you do to treat heartburn when you are pregnant?

Most cases of heartburn improve with lifestyle modifications. Here are some helpful tips for avoiding heartburn:

  • Abstain from smoking and drinking alcohol.
  • Eat five to six smaller meals throughout the day rather than three large meals. Do not eat late at night and avoiding known triggers (e.g., spicy or greasy foods, caffeine).
  • Wait an hour after eating to lie down
  • Avoid spicy, greasy, and fatty foods
  • Watch your weight. Extra pounds can make heartburn extra worse.

What can you do when you experience heartburn?

There are a few natural ways to relieve the symptoms:

  • Eat yogurt or drink a glass of milk
  • Try a tablespoon of honey in a glass of warm milk
  • Chew sugarless gum after meals. It helps reduce excess acid
  • Eat a very ripe papaya
  • Try almonds

What medications can I take if natural ways do not work?

Over-the-counter calcium- containing antacids like Tums or Rolaids may prove helpful in relieving your heartburn. However, too much calcium can block iron absorption, so don’t take tums at the same time you take your prenatal vitamin. Always speak to your health care provider before taking these products during pregnancy.

Some antacids contain high levels of sodium or sodium bicarbonate (baking soda), which can cause fluid buildup in body tissues, and other list aluminum (such as aluminum hydroxide or aluminum carbonate) as an ingredient, which can cause constipation and can even be toxic in large doses.

If your heartburn is persistent, your health care provider may prescribe acid blockers such as proton-pump inhibitors (PPIs) or H2 blockers. They’re generally considered safe during pregnancy.

If acid reflux occurs more than twice a week, or if you haven’t found relief after taking over-the-counter medications for more than two weeks, you may have a condition called gastroesophageal reflux disease (GERD) that requires specific lifestyle changes and medication – so be sure to talk to your health care provider for diagnosis and treatment.

Does having heartburn during pregnancy mean your baby has a lot of hair?

While there may be a link between the amount of heartburn you experience and the amount of hair your baby has, it’s not necessarily a cause-and-effect relationship. In other words, it’s probably not the hair on your baby’s head that’s actually causing you to feel the burn!
Below, you will find a list of foods to choose and foods to avoid by category, courtesy of webmd.

American

Whatever fast food is your favorite fare, pay attention to portion size. Overeating ups the chances of getting heartburn.

Avoid

  • Combo orders with sandwich, fries, drink
  • Double burgers
  • Onion rings, fries
  • “Supersize” orders
  • All-you-can-eat buffets
  • Country fried steak and all the fixings
  • Meats with fiery-hot BBQ sauce
  • Ketchup

Choose

  • Sandwich without fries
  • Grilled chicken sandwich
  • Plain baked potato
  • Salad bar with low-cal dressings
  • Turkey sandwich with vegetable soup
  • BBQ meat with no sauce, or mild sauce
  • Honey-based dressing

Coffee Shops

It isn’t just the coffee that might turn on the burn. Coffee shop fare can contain a lot of fat. If that’s one of your heartburn triggers, there is still tasty food for you here.

Avoid

  • Quiche
  • Fried chicken sandwich
  • French fries
  • Chicken fried steak
  • Donuts
  • Chocolate cake
  • Coffee
  • Tea with caffeine

Choose

  • Broth-based soups with vegetables
  • Grilled chicken sandwich
  • Plain Baked potato
  • Veggie burger
  • Whole wheat bagel
  • Fruit bowl for dessert
  • Decaf herbal tea
  • Mineral water

Breakfast

Breakfast is a perfect meal to squeeze in some of your fruit servings for the day. Pick ones that will be kind to you. The less citrus, the better.

Avoid

  • Grapefruit, oranges, tangerines
  • Coffee, orange juice
  • Bacon and fried eggs
  • Chocolate donuts or croissants
  • Sugary cereal

Choose

  • Apples, bananas, peaches
  • Low-fat milk, apple juice
  • Poached or hard-boiled eggs
  • Whole-wheat bagel and jam

Chinese

Some Chinese food may be spicy, but the menu at your favorite restaurant should have plenty of heartburn-free options.

 Avoid

  • Egg rolls or fried spring rolls
  • Deep fried wontons
  • Crab Rangoon
  • Szechuan pork or chicken
  • Fried rice
  • Sweet and sour pork or chicken
  • Hot and sour soup
  • Fried dessert

 Choose

  • Wonton soup
  • Steamed dim sum
  • Steamed dumplings
  • Stir-fried beef with broccoli
  • Plain or brown rice
  • Moo Goo Gai Pan or Mu Shu Pork
  • Egg drop soup
  • Steamed broccoli or eggplant
  • Fortune cookies

Dessert

Getting heartburn doesn’t mean you have to give up desserts. Just fine-tune what you order to avoid your triggers, such as chocolate.

Avoid

  • Chocolate candies
  • Chocolate cake with chocolate frosting
  • Chocolate chip cookies
  • Fried or chocolate pies
  • Mocha ice cream
  • Chocolate mocha cake
  • Mocha cookies
  • Key lime pie
  • Lemon meringue pie
  • Regular ice cream

Choose

  • Hard non-citrus candies — not mint
  • Angel food cake
  • Sugar cookies
  • Apple pie
  • Vanilla low-fat ice cream
  • Sponge cake
  • Vanilla or sugar cookies
  • Berries in season
  • Peach pie
  • Non-fat frozen yogurt

Fine Dining

If you like gourmet cuisine, you can still enjoy it without getting heartburn, even if fatty foods are a trigger for you. Here, how to cut back the fat, but not the taste.

Avoid

  • Creamy salad dressings
  • Dishes made with butter
  • Porterhouse steak and other high-fat cuts
  • Scalloped potatoes
  • Fish in lemon cream sauce
  • Fennel with lemon stuffing
  • Green beans with lemon
  • Spring greens with cherry tomatoes
  • Caprese salad
  • Ravioli with sun-dried tomatoes
  • Gourmet pizza with tomato paste
  • Lamb or lamb kabobs with mint sauce
  • Beet and mint salad
  • Mint and yogurt soup
  • Au gratin potatoes
  • Rib eye steaks
  • Fried vegetables
  • “Designer” coffee drinks
  • Wine, other alcohol

 Choose

  • Low-fat salad dressings
  • Dishes grilled with little oil
  • Nonfat frozen yogurt
  • London broil or filet mignon
  • Plain Baked potato
  • Grilled fish
  • Vegetable kabobs with grapes
  • Fennel with parsley
  • Green beans and onions
  • Mixed green salad with low-fat dressing
  • Ravioli with zucchini
  • Gourmet pizza with pesto base
  • Lean Beef kabobs
  • Roasted lamb
  • Asparagus or other vegetable soup
  • Brown rice
  • London broil or round steak
  • Steamed vegetables
  • Fruit bowl
  • Mineral water

Greek

If fatty foods trigger your heartburn, you can still enjoy Greek food.

Avoid

  • Fried calamari
  • Moussaka (lamb and beef)
  • Classic Baba Ganoush
  • Classic lentil soup
  • Zucchini with lemon
  • Artichoke with lemon
  • Fried fish
  • Gyro
  • Bakalava

Choose

  • Dolmas (rice in grape leaves)
  • Roast lamb
  • Shish kabob
  • Eggplant dip without tomato
  • Lentil soup without tomato
  • Fava beans
  • Grilled fish
  • Roasted vegetables
  • Fruit

Indian

If you love Indian food, don’t despair — yes, it’s often spicy, but you can avoid the burn with some wise menu choices.

Avoid

  • Pineapple chutney
  • Paneer Pakora (cheese and mint sauce)
  • Indian relish (red peppers)
  • Butter chicken (tomato sauce)
  • Tomato rice
  • Pappu Tomato
  • Samosas
  • Curries made with cream
  • Fried or stuffed breads
  • Curries with coconut cream or milk

Choose

  • Vegetable platter
  • Squash Vada
  • Asparagus with ginger
  • Malai Kofta (vegetarian meatballs, without sauce)
  • Tandoori chicken
  • Mango chicken salad
  • Papadum (thin lentil wafers)
  • Curries with a vegetable base
  • Naan (bread)
  • Roasted meat dishes such as chicken tikka

Italian

Tomatoes are a common heartburn trigger, and a big part of Italian fare. Eating Italian takes a little creativity to avoid the burn. But you can do it.

Avoid

  • Tomato sauces, toppings
  • Tomato toppings
  • Chicken parmigiana
  • Pepperoni, sausage, salami on pizza
  • Tiramisu
  • Coffee
  • Wine

Choose

  • Mushroom sauce, broth-based sauce
  • Crunchy bruschetta toast without toppings
  • Baked chicken without sauce
  • Broccoli, mushrooms, olives on pizza
  • Plain biscotti
  • Decaf herbal tea
  • Mineral water

Mexican

Salsa is traditional Mexican fare, but if tomatoes kick up your heartburn, you can still enjoy some South-of-the-border dishes.

Avoid

  • Chips and salsa
  • Tomatoes in tacos
  • Fried taco shells
  • Chile peppers
  • Mole sauce
  • Chorizo
  • Chimichangas
  • Margaritas
  • Flan

Choose

  • Chips with mild guacamole
  • Guacamole in tacos
  • Flour tortilla
  • Milder peppers, if you can tolerate them
  • Mild guacamole
  • Chicken in flour tortilla
  • Fajitas (no onions)
  • Mineral water

Seafood

Seafood can be kind to your heartburn — or cruel. If fried foods are your heartburn trigger, here’s what you need to know.

Avoid

  • Fried fish or shellfish
  • Balsamic vinegar glazed salmon
  • Seafood gumbo or bouillabaisse

Choose

  • Baked, broiled, or grilled fish or shellfish
  • Grilled salmon without sauce
  • Fish and potato stew (no tomatoes)

Thai

Spices are a mainstay of Thai cuisine. If spicy foods trigger your heartburn, choose wisely.

Avoid

  • Geow Grob (fried wontons)
  • Tod Mun (fried fish cake)
  • Gang Leang (spicy vegetable soup)
  • Tom Yum Goong (shrimp in spicy soup)
  • Tom Yum Hed (spicy oyster mushroom soup)
  • Moo Dang (BBQ pork with five spice marinade)
  • Pud Makua Yow (stir-fried eggplant with chili pepper)
  • Goong Ob Woonsen (shrimp with garlic)
  • Mee Grow Chow Wung (sweet and sour crispy fried rice)
  • Goew Tiew Kak (rice noodles in beef curry sauce)
  • Cha (Bright orange tea)
  • Pineapple mango upside down cake
  • Fried bananas

 Choose

  • Satay (marinated, grilled meat)
  • Thai salad rolls without sauce
  • Gang Jued Naw Mai Sod Gub Gai (fresh bamboo shoot soup)
  • Nam Gang (chicken broth)
  • Tom Yum Gai (lean chicken soup with lemongrass)
  • Neur toon (slow-cooked beef stew, hold the spices)
  • Grilled snapper
  • Ginger and chicken stir fry
  • Pad Thai (stir-fried rice noodles with chives, sprouts and shrimp)
  • Kow Su-ay (rice cooked in water)
  • Fug Tong Gang Buad (pumpkin in coconut milk)
  • Boa Loy (rice balls in coconut milk)
  • Saku Piak Maprow On (tapioca pudding in warm coconut milk)
Diego Wyszynski
Dr. Diego Wyszynski is the Founder and CEO of Pregistry. He is an expert on the effects of medications and vaccines in pregnancy and lactation and an accomplished writer, having published 3 books with Oxford University Press and more than 70 articles in medical journals. In 2017, he was selected a TEDMED Research Scholar. Diego attended the University of Buenos Aires School of Medicine and Johns Hopkins School of Public Health.

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