Getting hit with uncomfortable heartburn way more often than usual? Like morning sickness, breast tenderness, and fatigue, heartburn (or acid reflux) may occur during early pregnancy — and can persist until you give birth.
Here's why it happens and what you can do to put out the fire.
Is heartburn an early pregnancy symptom?
Heartburn or acid reflux can be an early pregnancy symptom, though it sometimes flares up later in pregnancy and isn't always one of the first signs that you're expecting.
"Heartburn is not a typical sign of early pregnancy. It's usually seen more in the third trimester," says Jennifer Wu, M.D., an OB/GYN in New York City and a member of the What to Expect Medical Review Board. "But in patients with existing heartburn, they may see it really worsen in early pregnancy."
The American College of Obstetricians and Gynecologists (ACOG) notes that heartburn can strike during the first trimester.[1] The problem can continue through the second and third trimesters too, but thankfully, pregnancy-related reflux typically goes away after giving birth, unless you were already prone to it before you got pregnant.
During the first trimester, you might experience heartburn alongside other early pregnancy symptoms including breast tenderness, fatigue, having to pee more often, food cravings or aversions, gassiness or bloating, and/or constipation.
"My heartburn gets so bad some nights, I’m up all night coughing and hurting and can’t get comfortable," says What to Expect Community member B9F.
That said, it's better to take a home pregnancy test than rely on symptoms alone to figure out whether you're pregnant. If the test is positive, you can make an appointment with your health care provider to have the results confirmed.
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What causes heartburn in early pregnancy?
Much of it has to do with hormones. Your body ramps up production of progesterone and relaxin during the first trimester, causing the valve at the entrance of your stomach to relax and not close as efficiently, according to KidsHealth From Nemours.[2]
As a result, it's easier for partially digested food and digestive juices to splash up from your stomach into your esophagus, causing that uncomfortable heartburn feeling.
The problem tends to get exacerbated later in pregnancy. As your uterus and baby grow, they put more pressure on your stomach, making it even easier for food and liquids in your stomach to come back up in the form of acid reflux.
"My heartburn has been worse than ever and nothing is helping!" laments one What to Expect Community parent who's in the third trimester. "I’m literally miserable ... It feels like I’m in my first trimester all over again, except at least back then I didn’t have any heartburn."
How to treat heartburn in early pregnancy
If you've ever dealt with heartburn before becoming pregnant, many of the same treatment methods apply now. Lifestyle changes are a good first step, since they can often stop heartburn before it starts. You can:
Eat smaller, more frequent meals.
Avoid eating within three hours of going to bed.
Avoid foods that seem to make your heartburn worse, like citrus fruits, tomatoes, chocolate, coffee or caffeine, fatty foods, mint, or spicy foods. "Tomatoes are the worst for heartburn," says Dr. Wu. "Patients often tell me they aren’t eating tomatoes, then I point out their cravings for pizza. That small amount of tomato sauce can cause a lot of misery later that night."
Use a second pillow to prop up your head when you go to sleep. "Don’t just elevate your head," advises Dr. Wu. "Try to sleep more upright to decrease reflux."
When heartburn hits and you need fast relief, certain foods or drinks might help neutralize the acid and help you feel more comfortable, including:
Yogurt or milk
Celery
Cucumber
Lettuce
Watermelon
Broth-based soups
Some teas (but check with your doctor, as certain herbal teas aren't recommended or safe during pregnancy)
"Having serious heartburn," says one What to Expect Community parent krtMAYBE21. "I get heartburn after eating acidic foods."
Medications can be an option when lifestyle changes aren't doing enough. Start by talking to your OB/GYN. Most heartburn medications are likely considered safe during pregnancy, the Cleveland Clinic says.Cleveland ClinicYour Guide to Pregnancy-Safe MedicationsSee All Sources [3]
However, your baby may be most sensitive to the effects of certain drugs during the first trimester. You and your doctor can weigh the pros and cons together and decide on a plan that feels right for you.
"Milk, yogurt, and even ice cream help to coat and soothe the esophagus, and may help you avoid taking medications in the first trimester," notes Dr. Wu.
If you and your doctor decide that meds are a good fit, you can try options like:
Aluminum hydroxide/magnesium carbonate (Gaviscon®) (occasional use only)
Famotidine (Pepcid AC®)
Aluminum hydroxide/magnesium hydroxide (Maalox®)
Calcium carbonate/magnesium carbonate (Mylanta®)
Calcium carbonate (Titralac® or Tums®)
Ranitidine (Zantac®)
Heartburn can hit during the first trimester, and it might get worse as your pregnancy progresses. The problem should ease up after you give birth, but lifestyle changes and doctor-approved medications can help you feel better in the meantime.
- Heartburn isn't one of the most common early signs of pregnancy, but it can affect some in their first trimester and beyond, especially for women who suffered from it before they got pregnant.
- Avoid acidic foods that can trigger heartburn, like tomatoes (yes, even those in pasta and pizza), citrus, spicy foods, fatty foods, and sometimes even chocolate and caffeine (especially in larger amounts).
- Hormones are to blame for the spike in acid reflux when you're expecting, which can get worse as your baby and uterus grow, pushing on your stomach and esophagus.
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