Managing heartburn and reflux

Heartburn is one of pregnancy’s most common gripes, especially from the second trimester onwards. There are two reasons it ramps up: pregnancy hormones relax the valve at the top of your stomach, so acid escapes back up more easily, and later on your growing uterus presses upward on your stomach. It’s uncomfortable — a burning behind the breastbone, sometimes a sour taste or mild nausea — but it’s harmless to you and your baby, and there’s plenty you can do to ease it.

How and what you eat helps the most. Try smaller, more frequent meals rather than three big ones, so your stomach is never over-full. Eat slowly, and stay upright — sitting or walking — for at least half an hour after eating rather than lying straight down. It’s worth noticing your own triggers and easing off them; common culprits are spicy, fatty, fried or acidic foods (think citrus, tomato), chocolate, fizzy drinks and caffeine. Sipping fluids between meals rather than gulping large amounts with food can help too.

At night, when heartburn often feels worst, a few changes make a real difference: don’t eat in the couple of hours before bed, raise the head of your bed a little (a wedge pillow, or blocks under the bedhead — propping pillows alone tends to just bend you at the waist), and sleeping on your left side can help keep acid where it belongs. Loose, comfortable clothing around your waist is kinder than anything that presses on your stomach.

If the simple measures aren’t cutting it, you don’t have to just suffer. Ask your GP, midwife or pharmacist about antacids that are safe in pregnancy — there are good options, and a pharmacist can point you to the right one rather than you guessing in the aisle. Don’t take leftover reflux medications or anyone else’s without checking first.

Beyond meals and medication, a few small comforts help in the moment. Some people find a glass of milk, a little yoghurt or sipping water eases the burn, and chewing sugar-free gum after eating boosts saliva, which helps wash acid back down. Keep drinks small and frequent rather than large, and resist the urge to slump on the couch right after dinner. And reassuringly — despite the old wives’ tale — heartburn says nothing about how much hair your baby will have; it’s just the plumbing of pregnancy, and it almost always vanishes the moment your baby is born.

One thing worth flagging: heartburn is usually nothing to worry about, but severe pain high up in your abdomen (especially just under your ribs on the right), can occasionally be a sign of something more than reflux — including, in later pregnancy, raised blood pressure or pre-eclampsia — particularly if it comes with a bad headache, vision changes, or sudden swelling. If you have those, contact your midwife or maternity unit promptly rather than putting it down to heartburn. The everyday burn after a big dinner, though, is just one of pregnancy’s nuisances — and it almost always disappears once your baby is born.