Remedies for Heartburn & Reflux During Pregnancy

Remedies for Reflux/Heartburn During Pregnancy. You don’t have to just suffer through and accept the pain. There are things you can to do relieve heartburn and reflux when you are pregnant. Why it happens, what’s actually safe to take, lifestyle changes that make a real difference, foods to avoid, and when to call your doctor.

Medical disclaimer: This post shares personal experience and general information only. It is not medical advice. Always consult your OB, midwife, or healthcare provider before taking any medication or supplement during pregnancy — including over-the-counter products. What is safe varies by trimester and individual health history.

Heartburn during pregnancy is one of those things nobody warns you about until you’re lying awake at 2 AM feeling like your chest is on fire. It affects more than half of all pregnant women — many severely — and it tends to get worse as pregnancy progresses, peaking in the third trimester.

I’ve dealt with reflux through all four of my pregnancies. Most of the time, I just suffered through it, assuming it was one of those things you simply have to endure. What I eventually learned — especially with my fourth pregnancy, when the reflux turned into a persistent cough — is that you don’t have to just accept it. There’s a lot you can actually do, and doing it proactively works far better than waiting until you’re already miserable.

This post covers everything I wish I’d known earlier: why pregnancy causes heartburn in the first place, what remedies are considered safe, which foods make it worse, and when symptoms are serious enough to warrant a call to your provider.

What’s covered in this guide

1. Why Pregnancy Causes Heartburn and Reflux
2. When It Typically Gets Worse
3. Lifestyle Remedies That Work
4. Foods to Avoid — and Foods That Help
5. Medications: What’s Generally Considered Safe
6. Getting Better Sleep Despite Heartburn
7. When Reflux Causes a Cough
8. When to Call Your Doctor
9. Frequently Asked Questions

Why Pregnancy Causes Heartburn and Reflux

Pregnancy heartburn isn’t just ordinary indigestion — it has two distinct physical causes that work together to make it worse than anything most women have experienced before.

The hormone effect. Progesterone, which surges during pregnancy to maintain the uterine lining and support fetal development, has a relaxing effect on smooth muscle throughout the body — including the lower esophageal sphincter (LES). The LES is the muscular valve at the base of the esophagus that normally keeps stomach acid where it belongs. When progesterone relaxes it, acid can more easily travel upward into the esophagus, causing the burning sensation of heartburn and the regurgitation of acid reflux.

The physical pressure effect. As the uterus grows, it presses upward on the stomach, physically reducing the stomach’s capacity and pushing its contents — including acid — toward the esophagus. This is why heartburn typically worsens in the second and third trimesters as the baby grows, and why it’s often worst after meals and when lying down.

Together, these two factors mean that even women who have never experienced heartburn in their lives can develop significant reflux during pregnancy — and women who already had mild reflux may find it becomes severe.

The good news
For most women, pregnancy heartburn resolves completely within days to weeks of delivery, once progesterone levels drop and the uterus returns to its normal position. It is a temporary condition, even when it feels permanent at 36 weeks.

When It Typically Gets Worse

Here is a timeline to watch out for.

First trimester

Mild to moderate: Progesterone is already elevated, causing some LES relaxation. Nausea and food aversions can complicate matters — an empty stomach can worsen acid, but eating may also trigger it. Heartburn is possible but usually less severe than later.

Second trimester

Increasing: As the uterus grows out of the pelvis and into the abdominal cavity, physical pressure on the stomach begins. Heartburn typically becomes more frequent and predictable. Meal timing and food choices start to matter more.

Third trimester

Often severe: Baby is large, stomach space is minimal, and progesterone remains high. This is when most women experience their worst symptoms — especially after meals, when bending over, exercising, and at night when lying flat. Both physical and hormonal factors are at their peak.

Within any given day, heartburn is usually worst in the evening and overnight — both because lying flat allows acid to travel more easily and because dinner is typically the largest meal of the day. Many women find that symptoms that were manageable in the morning become severe by 9 or 10 PM.

Lifestyle Remedies That Work

Before reaching for medication, lifestyle adjustments can make a substantial difference — and for mild-to-moderate heartburn, they may be all you need. Even if you do end up using medication, these strategies will make the medication more effective by reducing how much acid your stomach produces in the first place.

1-Stay upright after eating

Gravity is your best friend when it comes to keeping acid where it belongs. After any meal or snack, try to remain upright — sitting or standing — for at least 30–60 minutes before lying down. This is one of the single most effective non-medication strategies during pregnancy.

This is the same principle used for babies with reflux: keeping them upright after feeds. It works for the same physiological reason — gravity keeps stomach contents from traveling upward.

2-Eat smaller, more frequent meals

A full stomach creates more pressure against the LES and gives acid more to work with. Eating 5–6 smaller meals instead of 3 large ones keeps the stomach less full at any given time, reducing both the volume of acid produced and the upward pressure on the esophageal valve.

This also happens to align well with the general pregnancy nutrition advice to graze throughout the day rather than eating large meals — the growing uterus reduces stomach capacity anyway, making large meals uncomfortable regardless of reflux.

3-Don’t eat close to bedtime

Eating within 2–3 hours of lying down is one of the most reliable triggers for nighttime heartburn. Your stomach is still actively producing acid to digest the food, and lying down removes the gravitational barrier keeping it in your stomach.

Try to finish dinner at least 2–3 hours before you plan to lie down. If you’re hungry later in the evening, very small, non-acidic snacks (a few crackers, a small piece of cheese) are less problematic than a full meal. I also found limiting water close to bedtime helped — less fluid in the stomach means less to reflux upward.

4-Prop yourself up while sleeping

Elevating the head of your bed or using a wedge pillow under your upper body (not just your head) keeps stomach acid from traveling upward while you sleep. The elevation needs to start at your torso — a standard pillow under your head alone doesn’t achieve the same effect because your esophagus remains level with your stomach.

A pregnancy wedge pillow or extra firm body pillow can work well for this. Many women find sleeping at a 30–45 degree incline significantly reduces nighttime symptoms. It takes some getting used to, but on bad nights it can be the difference between sleeping and not sleeping.

5-Stay ahead of symptoms — don’t wait for a flare

This was one of the biggest practical lessons from my own experience. I used to wait until the burning was severe before taking antacids, by which point it was much harder to get under control. Taking a small antacid dose at the first hint of discomfort — or even proactively before a meal you know will be a trigger — works far better than trying to fight an established flare.

Think of it the way you’d think about pain management generally: staying ahead of pain is more effective than playing catch-up once it’s severe.

6-Wear loose, comfortable clothing

Tight waistbands and constrictive clothing put external pressure on the abdomen, which in turn increases pressure on the stomach and LES. During pregnancy — when the abdomen is already under significant internal pressure from the growing uterus — anything adding additional external pressure can worsen reflux. Loose, comfortable maternity clothes are more than just a comfort preference; they can genuinely reduce acid reflux frequency.

7-Don’t bend at the waist after eating

Bending forward at the waist (as opposed to squatting at the knees) compresses the abdomen and can push stomach contents toward the esophagus. After meals, if you need to pick something up or reach low, try to squat rather than bend forward at the waist. This is a small habit change that can make a noticeable difference for women with moderate to severe reflux.

8-Try chewing gum after meals

Chewing gum stimulates saliva production, and saliva is naturally alkaline — it helps neutralize acid in the esophagus. Several studies have found that chewing sugar-free gum for 30 minutes after meals can reduce acid exposure in the esophagus. It’s a simple, safe, zero-cost strategy worth trying. Choose a non-mint flavor if peppermint is a trigger for you (see the foods section below).

9-Keep a trigger log

Reflux triggers are highly individual. What causes a flare for one woman may be completely fine for another. Keeping a simple note for a week or two — what you ate, what time, and how your symptoms were 30–60 minutes later — can reveal patterns that allow you to specifically target your own triggers rather than avoiding everything on a generic “avoid” list. Some women find spicy food is their main trigger; others find caffeine, citrus, or even mint is worse. You’ll only know by tracking it.

Foods to Avoid — and Foods That May Help

Diet is one of the most modifiable factors in pregnancy heartburn management. Not all foods affect all women the same way — but the following are the most commonly reported triggers and the foods that are generally better tolerated.

Food / Drink	Effect	Why
Spicy foods	Avoid	Irritates the esophageal lining and slows gastric emptying, giving acid more time to travel upward
Citrus fruits & juice	Avoid	Highly acidic; directly lowers pH in the esophagus and can trigger LES relaxation
Tomatoes & tomato-based sauces	Avoid	Acidic and have been shown to worsen reflux symptoms in many people
Chocolate	Avoid	Contains methylxanthines that relax the LES; also stimulates acid secretion
Coffee & caffeinated drinks	Avoid	Caffeine relaxes the LES and stimulates stomach acid production
Carbonated drinks	Avoid	Bubbles increase stomach pressure and can push acid upward; also acidic
Fried & fatty foods	Avoid	Slow gastric emptying significantly, keeping stomach fuller longer and increasing reflux risk
Peppermint & spearmint	Avoid	Despite feeling soothing, mint relaxes the LES — worsening reflux even while it cools the burning sensation
Alcohol	Avoid	Relaxes the LES and irritates the esophagus — and is contraindicated in pregnancy entirely
Onions & garlic	Avoid	Common triggers for LES relaxation in many people; raw forms are worse than cooked
Oatmeal & whole grains	Generally safe	High-fiber, low-acid; absorbs stomach acid and provides satiety without triggering reflux
Lean protein (chicken, fish, turkey)	Generally safe	Low-fat proteins are easier to digest and less likely to relax the LES than fatty meats
Non-citrus fruits (bananas, melons, apples, pears)	Generally safe	Low-acid fruits that don’t irritate the esophagus; bananas in particular have a natural antacid effect
Ginger	Generally safe	Has natural anti-nausea and mild antacid properties; ginger tea or ginger chews can provide relief
Almonds	Generally safe	Alkaline-forming food that some women find neutralizes stomach acid after meals
Milk / dairy	Individual	Cold milk may temporarily soothe burning, but the fat and protein can stimulate more acid production afterward — a temporary fix that can backfire
Apple cider vinegar	Individual	Counterintuitively, some women find small amounts help; others find it worsens symptoms. Check with your provider before trying.

💡 The “Tabasco exception”
My neighbor, during one of my pregnancies, swore that Tabasco sauce — which is technically a trigger food — reduced her reflux. She was not alone; some people find that the initial acid from hot sauce signals the stomach to reduce its own acid production. Bodies are individual. Don’t dismiss something just because it’s counterintuitive — track your own response and trust what your body tells you.

Medications: What’s Generally Considered Safe

When lifestyle and dietary changes aren’t enough — or when symptoms are severe — medication can provide significant relief. Always consult your OB or midwife before starting any medication during pregnancy, including over-the-counter products. Medication safety varies by trimester, dosage, and individual health history.

Antacids (first line)

Antacids neutralize stomach acid that has already been produced. They work quickly (within minutes) and are generally considered safe for use during pregnancy when used as directed. Common options include calcium carbonate (Tums, Rolaids) and aluminum/magnesium hydroxide combinations (Mylanta, Maalox).

My personal go-to since my first pregnancy has been Mylanta. My doctor confirmed it was safe and told me I could take a significant amount without concern for the baby, which gave me peace of mind to use it when I needed it. I learned over time that taking it at the first sign of symptoms — rather than waiting until I was in significant pain — was far more effective.

⚠️ Antacid ingredients to be aware of
Some antacids contain sodium bicarbonate (baking soda) or aspirin, which are not recommended during pregnancy. Antacids with sodium bicarbonate can cause fluid retention and affect electrolyte balance. Check labels carefully and confirm with your provider if you’re unsure. Calcium carbonate-based antacids (like Tums) have the added benefit of contributing to your daily calcium intake.

H2 blockers (for more significant symptoms)

H2 blockers such as famotidine (Pepcid) reduce the amount of acid the stomach produces rather than neutralizing it after the fact. They take 30–45 minutes to work but provide longer-lasting relief (up to 12 hours) than antacids. Famotidine (Pepcid) has generally been considered acceptable during pregnancy by many providers when antacids alone aren’t sufficient, though guidance does evolve — check with your provider for current recommendations. Note that ranitidine (Zantac) was voluntarily recalled in 2020 due to contamination concerns; famotidine is its replacement.

Proton pump inhibitors (PPIs)

PPIs such as omeprazole (Prilosec OTC) and esomeprazole (Nexium) are the strongest over-the-counter option. They block acid production more completely than H2 blockers and are typically used for more severe or persistent symptoms. My doctor recommended trying Prilosec OTC when my reflux-related cough wasn’t responding adequately to other measures — one pill once daily made a significant difference.

The safety profile of PPIs during pregnancy has been studied fairly extensively. Most data suggest they are not associated with significant fetal risk when used appropriately, but they are typically recommended only when symptoms are not controlled by antacids and H2 blockers, and under the guidance of a healthcare provider.

📌 The general medication hierarchy for pregnancy reflux
Most providers follow a step-up approach: start with lifestyle changes and diet modification → add antacids (Tums, Mylanta) as needed → try an H2 blocker (famotidine/Pepcid) if antacids aren’t enough → consider a PPI (omeprazole/Prilosec) for severe or persistent symptoms under provider guidance. Skip steps if symptoms are severe from the start — don’t suffer unnecessarily.

Natural and alternative remedies

Ginger has a long history of use for nausea and digestive discomfort and is generally considered safe during pregnancy. Ginger tea, ginger chews, and ginger ale (real ginger, not just ginger-flavored) may provide mild relief. Papaya enzymes (as chewable tablets, not papaya fruit itself in large amounts) are sometimes used by pregnant women for digestive relief, though evidence is limited — check with your provider. Slippery elm lozenges coat the esophagus and may provide soothing relief, though again, consult your provider before using.

Getting Better Sleep Despite Heartburn

Nighttime heartburn is often the most disruptive part of pregnancy reflux — lying flat removes gravity’s protective effect right when you most need to rest. Here are strategies specifically for getting better sleep:

Elevate your upper body. Use a pregnancy wedge pillow or extra firm pillow positioned under your torso — not just your head — to create a 30–45 degree incline. This keeps your esophagus above your stomach, making upward acid travel significantly harder. It takes adjustment but is one of the most effective sleep strategies.

Sleep on your left side. The stomach is positioned slightly to the left in the body, meaning sleeping on your left side positions the stomach lower than the esophagus. Left-side sleeping has been shown to reduce acid exposure in the esophagus compared to right-side sleeping. Left-side sleeping is also generally recommended during pregnancy for circulation reasons — so this is a double win.

Establish a strict food cutoff. No eating within 2–3 hours of lying down. If you’re genuinely hungry in the late evening, a small, low-acid snack (plain crackers, a banana, a small piece of cheese) is less risky than a full meal. I also found that limiting fluids — especially acidic drinks — in the last hour or two before bed improved my nighttime symptoms, with the bonus of fewer bathroom trips.

Take your antacid before you feel it. If nighttime heartburn is a reliable occurrence, consider taking an antacid or H2 blocker before you lie down rather than waiting to wake up in pain. Ask your provider about the best timing for any medication you’re using.

Keep antacids on the nightstand. For the nights when heartburn wakes you up anyway, having antacids within arm’s reach means you can take one immediately without fully waking yourself up getting out of bed. Chewable calcium carbonate tablets (Tums) are ideal for this — no liquid needed, fast-acting, and easy to handle half-asleep.

When Reflux Causes a Cough

One of the less-discussed symptoms of acid reflux is a chronic cough. When acid from the stomach reaches the back of the throat and airway, it can irritate the vocal cords and airways, triggering a persistent dry cough that seems to have no obvious cause. This is sometimes called laryngopharyngeal reflux (LPR) or “silent reflux” — it doesn’t always come with the classic burning sensation in the chest, so many people don’t connect the cough to reflux at all.

During my fourth pregnancy, I dealt with this directly. The burning wasn’t always severe, but the coughing was constant — and coughing repeatedly with a third-trimester belly and a weakened pelvic floor creates its own set of very specific problems. Managing the reflux more aggressively (with both lifestyle measures and medication) was the only thing that helped the cough.

Signs that your cough may be reflux-related: it’s worse after meals and when lying down, it’s a dry nonproductive cough, it’s worse in the morning, and it doesn’t respond to typical cough remedies. Tell your provider about a persistent cough during pregnancy so they can evaluate it properly.

💡 Managing reflux-related cough
All the standard reflux remedies apply — but for cough specifically, elevating the head of the bed is particularly important, since acid reaches the throat most easily while lying flat. Staying strictly ahead of reflux with regular medication (as directed by your provider) rather than treating reactively can significantly reduce cough frequency. See the linked post on pregnant and coughing for more.

When to Call Your Doctor

Most pregnancy heartburn, while very uncomfortable, is a normal physiological response to the hormonal and physical changes of pregnancy. However, some symptoms warrant a call to your provider sooner rather than later:

!-Heartburn that doesn’t respond to any treatment

If you’ve tried antacids, H2 blockers, and lifestyle changes without relief, your provider can evaluate whether prescription medication or further investigation is warranted. You don’t have to just suffer — there are stronger options available.

!-Difficulty swallowing or pain when swallowing

Dysphagia (difficulty swallowing) during pregnancy should be evaluated by your provider, as it can indicate esophageal inflammation or other conditions that need assessment.

!-Vomiting blood or dark material

This is always a reason to contact your provider or seek urgent care. Dark or bloody vomit can indicate esophageal irritation or injury that needs to be evaluated promptly.

!-Significant chest pain

While heartburn can feel like chest pain, significant chest tightness or pressure — especially if it radiates to the arm, jaw, or back — should always be evaluated to rule out cardiac causes. This is rare in healthy pregnant women but worth taking seriously.

!-Unexplained weight loss or inability to keep food down

If reflux is so severe that you’re unable to eat or maintain nutrition, your provider needs to know. Hyperemesis gravidarum (severe pregnancy nausea and vomiting) and severe GERD can both interfere with nutrition in ways that need medical management.

!-Upper abdominal pain in the third trimester

While most upper abdominal discomfort in late pregnancy is baby-related or digestive, severe upper right quadrant pain in the third trimester can occasionally be a sign of conditions like preeclampsia with severe features or HELLP syndrome. Always mention persistent upper abdominal pain to your provider.

---

Frequently Asked Questions

Is it normal to have heartburn every single day during pregnancy?

Yes — daily heartburn during pregnancy, especially in the third trimester, is very common. Studies suggest that more than 50% of pregnant women experience heartburn, and for many it is a daily occurrence in the later months. This doesn’t mean you have to live with it without treatment. Daily symptoms are a good reason to discuss a consistent management plan — including the possibility of daily medication — with your provider rather than treating each episode reactively.

Can Tums cause any problems during pregnancy?

Tums (calcium carbonate) are generally considered safe during pregnancy and are commonly recommended by OBs. They even provide a modest calcium supplement. However, taking very large amounts regularly can theoretically affect calcium and phosphorus balance — another reason to use the minimum effective dose and check with your provider about appropriate limits for your situation. Avoid antacids containing sodium bicarbonate or aspirin, which are not recommended in pregnancy.

Is Zantac safe to take during pregnancy?

Ranitidine (Zantac) was voluntarily recalled in 2020 due to contamination concerns (NDMA, a potential carcinogen) and has largely been pulled from the market. Famotidine (Pepcid) has become the recommended alternative H2 blocker. If you still have old Zantac in your medicine cabinet, don’t use it — and don’t purchase any product labeled Zantac without confirming the active ingredient. Always discuss H2 blocker use with your OB before starting.

Does bad pregnancy heartburn mean my baby has a lot of hair?

This is one of those old wives’ tales that actually has some interesting research behind it. A 2006 study found a correlation between heartburn severity and neonatal hair — the proposed mechanism being that fetal hair follicles may produce hormones that also relax the esophageal sphincter. That said, it’s a correlation, not a reliable predictor. Plenty of mothers have severe heartburn and bald babies, and vice versa. It’s a fun thing to wonder about, but don’t count on it as a hair forecast.

Will heartburn go away after delivery?

For most women, yes — within days to a few weeks after delivery, as progesterone levels drop and the uterus returns to its pre-pregnancy size. The relief is often dramatic and fast. If significant heartburn persists well beyond delivery (more than 4–6 weeks postpartum), it’s worth discussing with your provider, as that may indicate pre-existing GERD that was unmasked or worsened by pregnancy.

Can drinking water help with pregnancy heartburn?

In small amounts, yes — sipping water can help dilute and neutralize stomach acid. However, drinking large amounts of water with meals can actually worsen heartburn by increasing stomach volume and putting more pressure on the LES. The general guidance is to sip water between meals rather than drinking large amounts during eating. And as noted above, reducing fluids close to bedtime can help with nighttime symptoms specifically.

My heartburn started early in the first trimester. Is that normal?

Yes — progesterone rises quickly after conception, and its LES-relaxing effect can produce heartburn symptoms even before the uterus has grown large enough to cause physical pressure on the stomach. Some women experience noticeable heartburn from as early as 6–8 weeks. For these women, the third trimester often brings a double whammy of hormonal and physical triggers. Starting lifestyle management strategies early is worth it.

You don’t have to just suffer through it

That was my approach for most of my pregnancies — accepting heartburn as one of those unavoidable things and enduring it. Looking back, I wish I’d been more proactive sooner. The combination of staying ahead of symptoms with antacids, eating smaller meals earlier in the evening, sleeping propped up on my left side, and avoiding my specific trigger foods made a genuinely significant difference once I started paying attention to it.

None of these strategies are complicated. Most cost nothing. The hard part is remembering to do them consistently when you’re tired and just want to eat dinner and lie down — but the payoff in sleep quality and daily comfort is real.

Talk to your OB or midwife about what’s appropriate for your specific situation. Pregnancy heartburn is incredibly common and very treatable — you don’t have to white-knuckle it until delivery.

Now, what tips and tricks work for you? Even if something I said worked–or didn’t work–, please share that so other moms know what is most likely to help them in this situation.

I would love to hear some new remedy I have never heard of though (speaking of, I was just reading through this post from when I was pregnant with McKenna and there are several interesting reflux helps ideas there–so read those comments for more ideas)!

Related pregnancy posts

• Pregnant and Coughing? What to Do
• Morning Sickness Remedies
• Exercise and Pregnancy
• Pain Is Not a Pregnancy Requirement
• Surviving Bed Rest
• It’s Okay Not to Love Being Pregnant
• Pregnancy: Weight Gain and Eternal Perspective

This post first appeared on this blog in May of 2012