Heartburn in pregnancy is common, and the safest first steps are usually small diet and lifestyle changes plus pregnancy-safe antacids if your clinician says they’re okay. Helpful measures include eating smaller meals, avoiding trigger foods, not lying down right after eating, and sleeping with your head and shoulders elevated.

What usually helps

  • Eat 4 to 6 smaller meals instead of 2 or 3 large ones.
  • Avoid common triggers such as spicy, fatty, greasy, tomato-based, citrus, caffeinated, and carbonated foods/drinks.
  • Don’t eat within 3 hours of bedtime.
  • Stay upright after meals, and avoid bending over or lying flat right away.
  • Sleep with your upper body raised; a wedge pillow or elevating the head of the bed can help.
  • Left-side sleeping may also reduce reflux at night.

Medicines that are often used

  • Antacids such as calcium carbonate are commonly used in pregnancy, but some types are not appropriate, so it’s best to check with a pharmacist, midwife, or doctor first.
  • Alginates can help keep stomach acid from coming back up.
  • If symptoms persist, a clinician may recommend an H2 blocker or a proton pump inhibitor.

Things to avoid

  • Avoid smoking and alcohol, which can worsen heartburn and are unsafe in pregnancy.
  • Don’t take antacids too close to iron or folic acid supplements, because they can reduce absorption.
  • Avoid self-treating severe or new symptoms without medical advice, especially if you also have headache, swelling, vomiting blood, or dark stools.

When to call a clinician

  • Heartburn is severe, frequent, or not improving with home changes.
  • You have trouble swallowing, vomiting, chest pain, blood in vomit, or black stools.
  • Symptoms come with headache or swelling in the hands or face, especially in the third trimester.

Quick Scoop

A simple first try is: smaller meals, no food near bedtime, stay upright after eating, and raise your head at night. If that’s not enough, ask about pregnancy-safe antacids or other medicines.