Heartburn is a common discomfort that many pregnant women experience. It often feels like a burning pain in the chest or throat after eating and occurs when stomach acid escapes into the esophagus. During pregnancy, heartburn can become more frequent due to a combination of hormonal changes and physical pressure from the growing uterus.

Although heartburn is rarely dangerous, it can make daily life and sleep uncomfortable. The good news is that there are safe and effective ways to manage symptoms while pregnant. From simple lifestyle adjustments to doctor-approved medications, here are five approaches to find relief.

Change Your Eating Habits

Why It Helps
Pregnancy slows digestion, which means food may remain in the stomach longer. A full stomach increases the likelihood of acid reflux. Eating smaller meals throughout the day reduces pressure and gives your body more time to process food comfortably.

Practical Tips

  • Switch to five or six small meals instead of two or three large ones.

  • Stop eating at least three hours before bedtime to reduce nighttime reflux.

  • Limit common trigger foods, including:

    • Citrus fruits and tomatoes

    • Coffee and caffeinated drinks

    • High-fat and fried foods

    • Peppermint or spearmint

    • Spicy meals and sauces

Keeping a food diary can help you identify your personal triggers. Not everyone reacts to the same foods, so tracking what you eat and when symptoms appear gives you clearer guidance on what to avoid.

Bottom Line
Adjusting meal size, timing, and food choices is a safe first step. While these changes may not eliminate heartburn completely, they often reduce mild symptoms and should be tried before moving to stronger treatments.

Consider Antacids

What They Do
Over-the-counter (OTC) antacids like Tums (calcium carbonate) work by neutralizing stomach acid. They provide fast, short-term relief and are generally safe during pregnancy when used appropriately.

Important Notes

  • Stick to calcium, magnesium, or aluminum-based antacids.

  • Avoid Pepto-Bismol (bismuth subsalicylate) and sodium bicarbonate antacids (e.g., Alka-Seltzer), which are not safe during pregnancy. Sodium bicarbonate can alter blood chemistry and cause swelling.

  • Take antacids separately from prenatal vitamins, iron, or folic acid, as they may interfere with absorption.

Possible Side Effects

  • Constipation or diarrhea (depending on the formula)

  • Mild headaches or stomach upset

Extra Support
Sometimes doctors recommend pairing antacids with alginates, which form a gel-like barrier on top of stomach acid, providing an extra layer of protection against reflux.

Elevate Your Head

Why Position Matters
Lying flat after meals increases abdominal pressure and encourages acid to escape into the esophagus. This is especially problematic during pregnancy when the uterus already presses on the stomach.

Strategies To Try

  • Avoid lying down for about three hours after eating.

  • If you need to rest, recline with your upper body elevated instead of lying flat.

  • At night, use a foam wedge pillow or raise the head of your bed by 6–8 inches with blocks or risers.

Research supports that elevating the upper body reduces nighttime reflux and improves sleep quality. While this is not a cure, it is a simple way to minimize discomfort without medication.

Take H2 Blockers

How They Work
H2 blockers — also called H2 receptor antagonists — reduce stomach acid production by blocking histamine receptors in the stomach lining. They are available both OTC and by prescription.

Pregnancy Safety
H2 blockers such as Pepcid (famotidine) are considered safe for short-term use during pregnancy. They are often the next step if lifestyle changes and antacids don’t provide enough relief.

Possible Side Effects

  • Mild diarrhea or constipation

  • Headaches

  • Rare interactions with certain medications (like warfarin or some antidepressants)

When To Use
If your symptoms occur several times per week or disrupt sleep despite trying home remedies, H2 blockers may provide more consistent relief. Always consult a healthcare provider before starting them.

Try Proton Pump Inhibitors (PPIs)

How They Work
Proton pump inhibitors (PPIs) — such as Prevacid (lansoprazole) or Prilosec (omeprazole) — are stronger than H2 blockers. They block the enzyme responsible for acid production, offering longer-lasting relief and helping heal esophageal irritation if present.

Safety During Pregnancy
Most PPIs are considered safe in pregnancy, but they should only be used if:

  • Lifestyle changes and antacids fail

  • H2 blockers aren’t effective

  • Symptoms are severe or complications arise

Potential Side Effects

  • Headache

  • Diarrhea or constipation

  • Dizziness

  • Rarely, an increased risk of infections with prolonged use

Key Point
PPIs are effective but should be reserved for cases where other options don’t work. Always use the lowest effective dose and follow your doctor’s instructions.

Quick Review

Heartburn is common in pregnancy due to hormonal changes and physical pressure on the stomach. While often harmless, it can be uncomfortable and affect sleep and daily activities.

Safe and effective relief can come from:

  1. Eating smaller meals and avoiding trigger foods

  2. Using pregnancy-safe antacids in moderation

  3. Elevating the head while lying down

  4. Trying H2 blockers if lifestyle changes aren’t enough

  5. Using PPIs only when other treatments fail, under medical supervision

If your symptoms are severe, persistent, or accompanied by warning signs like difficulty swallowing, vomiting blood, or severe chest pain, seek medical attention immediately.