Heartburn and reflux in pregnancy: 10 practical tips and a calmer night

A burning feeling behind the breastbone, a sour or bitter taste in the mouth, discomfort that gets worse when you lie down… Heartburn is very common in pregnancy and for many people becomes more noticeable as the weeks go on. It is unpleasant, but it is usually a natural side effect of pregnancy and does not harm the baby. The good news is that small changes in your daily routine often make a difference.

Why does it happen?

Two main factors stand out. The first is hormones: the rising progesterone in pregnancy relaxes the valve between the stomach and the food pipe. When stomach contents move upwards, the lining of the food pipe is irritated. The second is the growing womb: later in pregnancy it presses on the stomach and makes it easier for acid to be pushed upwards, especially after meals. The stomach may also empty a little more slowly in pregnancy.

That is why symptoms often start or become clearer after week 14 and can peak in the last months. For some people they appear in the first weeks too.

What does it feel like?

• Burning in the chest or throat
• Sour or bitter fluid coming up into the mouth
• Bloating, burping and a feeling of fullness after eating (indigestion)
• Discomfort that gets worse when lying down or bending forward
• In some people a mild cough, a need to clear the throat or hoarseness

10 tips that help right away

There is no single miracle fix, but small adjustments can work together.

1. Make portions smaller. Five or six small meals a day strain the stomach less than three large ones.
2. Eat slowly. Chewing well, not rushing and pausing briefly between bites helps.
3. Get to know your triggers. Fried food, very spicy dishes, chocolate, caffeine, fizzy drinks, citrus fruit and tomato-based dishes make symptoms worse for some people. Yours may differ; a short note can help.
4. Leave a gap between eating and lying down. Try to finish your last meal at least two to three hours before bed.
5. Raise your upper body. Raising the head of the bed, or supporting your back and shoulders with pillows, can reduce acid moving upwards. An extra pillow under the head alone is often not enough.
6. Dress comfortably. Clothes that squeeze the tummy or waist can increase pressure on the stomach.
7. Spread out your fluids. Instead of drinking a lot during meals, sip between meals.
8. Stay upright after eating. Sit or take a gentle walk rather than lying down straight away.
9. Try lying on your left side. It helps some people; still, the position in which you sleep most comfortably matters.
10. Sugar-free gum or a glass of milk. Some people get short relief from chewing gum (it increases saliva) or from cold milk; you can see by trying whether it works for you.

For a more comfortable night

Heartburn gets worse lying down because gravity no longer keeps acid down. Keeping dinner early and light, drinking less before bed, raising the upper body and wearing loose nightwear can make the night easier. If burning wakes you, sitting upright on the edge of the bed, taking a few sips of water and waiting a little is often enough. For more on sleep you can also look at the sleep articles in the Guide.

Which foods tend to feel easier?

Everyone's triggers are different, but these are often better tolerated:

• Plain yoghurt, yoghurt drinks, dairy (for some people)
• Boiled or grilled vegetables, chicken and fish
• Oats, wholegrain bread, rice
• Light fruit such as banana or melon
• Low-fat, slowly eaten, lukewarm rather than hot meals

If you wonder whether a food is suitable in pregnancy, you can check the Is it safe to eat? section in the app. Being suitable does not mean it will not cause heartburn for you; watching your own body is the best guide.

What might a day look like?

This is not a rule, just a rough frame: oats or wholegrain bread with cheese at breakfast; two hours later yoghurt and a banana; grilled chicken or a vegetable dish with rice at lunch; a handful of raw almonds or a plain cracker in the afternoon; an early supper of soup and a light main dish. Only a few sips of water before bed. Even putting your phone down and chewing slowly makes a clear difference for some people.

It is also usual for the same meal to cause burning one day and not the next; tiredness, stress and portion size can play a part. Do not blame yourself when a day goes badly.

Do not forget the emotional side

Burning that lasts for weeks can break your sleep and increase tiredness and tension. You do not have to play down your discomfort or stay silent because it will pass anyway. Asking someone close to you to help with dinner, or taking short naps during the day, can make this period easier.

About medicines

When these measures are not enough, there are stomach-protecting options that are suitable in pregnancy. Your doctor should decide which one, when and for how long. Before buying anything at the pharmacy on your own, tell your doctor or pharmacist you are pregnant and ask; some products may not be suitable in pregnancy. Your doctor can suggest an option that fits your situation.

When to contact your doctor

• Heartburn clearly disturbs daily life, eating or sleep
• You have difficulty swallowing or pain when swallowing
• You are losing weight, vomiting constantly or cannot eat and drink enough
• There is blood in your vomit or your stools are black
• Severe pain in the upper right abdomen, together with a headache, blurred vision or sudden swelling of the hands and face (this can be a sign of a blood-pressure-related condition, so get checked without delay)
• If pain spreads to your back or arm, you break into a sweat, or you have chest pain and shortness of breath, call 112 (in Turkey) or your local emergency number, or go to the nearest emergency department

Frequently asked questions

Does heartburn harm the baby? No. Heartburn does not harm the baby; it only bothers you. That is why it is worth trying to find relief.

Does it have anything to do with the baby having a lot of hair? It is a popular saying, but no clear scientific link has been shown. You do not have to put your discomfort down to that.

Why is it worse at night? Lying down lets acid rise easily. Raising the upper body and finishing your last meal early matter for this reason.

Can I try new foods? Of course. If something triggers symptoms, start with small amounts and watch how your body responds.

Are reflux and indigestion the same thing? They are very similar. Reflux is burning and a sour taste from acid moving up; indigestion is fullness, burping and discomfort in the upper abdomen. They can occur together, and the suggested measures largely overlap.

What happens after birth? As the womb shrinks and hormones return to their usual levels, symptoms usually settle within days or weeks.

A sensitive digestive system in pregnancy is temporary, and being patient with yourself is part of the care. This article is for information only; your doctor's or midwife's advice for your own situation comes first.