Managing acid reflux in the third trimester

Hormonal effects can relax the barrier between the stomach and oesophagus, while the growing uterus increases pressure on the stomach. This can cause heartburn, sour fluid in the mouth, belching, throat irritation, or discomfort after meals and when lying down.

Digestion may feel slower during pregnancy, and there is less room for the stomach as pregnancy advances. Large portions, bending after meals, and lying flat can therefore bring symptoms on more readily. The pattern may fluctuate from day to day depending on meal size, timing, and body position.

Burning behind the breastbone is compatible with reflux, but pregnancy does not make every upper abdominal or chest symptom harmless. Pain location, severity, duration, and associated symptoms help maternity teams distinguish reflux from problems requiring prompt evaluation.

Try modest portions more often, eat slowly, remain upright after meals, and leave time between the evening meal and bed. Identify your own food or drink triggers instead of removing many foods unnecessarily. Sleeping with the upper body elevated and lying on the left side may reduce night-time reflux for some people.

Check any antacid, alginate, herbal product, or acid-reducing medicine with your maternity clinician or pharmacist before use. Some products contain ingredients or amounts of sodium that may not suit everyone, and antacids can interfere with the absorption of iron or other medicines if taken too close together. Follow personalised spacing advice.

Contact your maternity team promptly for severe or persistent pain beneath the ribs or in the upper abdomen, a severe headache, visual changes, sudden swelling, vomiting that prevents fluids staying down, reduced fetal movement, vaginal bleeding, or any symptom that feels markedly different from your usual reflux.

Emergency assessment is needed for severe chest pain, breathing difficulty, fainting, vomiting blood, black stools, or pain spreading to the arm, jaw, back, or shoulder. Arrange a routine review when reflux repeatedly disrupts eating or sleep, swallowing becomes difficult, or recommended measures are not controlling symptoms.

Ask which reflux medicine fits your pregnancy and medical history, how to separate it from prenatal supplements, and what duration of use is appropriate. Confirm whom to contact if pain changes character or comes with headache, swelling, visual symptoms, vomiting, or altered fetal movement.