What causes heartburn in pregnancy?

Slower movement of food through the digestive system can add to reflux during pregnancy. Symptoms may include burning behind the breastbone, a sour taste, burping or food coming back up, often after eating or when lying down. Large or rich meals, spicy foods, caffeine and eating close to bedtime can aggravate symptoms for some people, but triggers vary. Heartburn can occur at any pregnancy stage and does not mean that anything is wrong with the baby.

Try smaller meals, eat slowly and remain upright after food. Avoid your personal triggers, leave time between the evening meal and bed, and raise the head and shoulders when sleeping. Loose clothing may reduce pressure around the abdomen. If these changes are insufficient, ask a pharmacist, midwife or doctor which antacid, alginate or acid-reducing medicine is suitable in pregnancy. Mention other medicines and supplements because antacids can affect how some products are absorbed.

Seek emergency help for crushing or severe chest pain, breathing difficulty, faintness, sweating, or pain spreading to the arm, jaw or back. Contact your maternity team urgently for severe or persistent pain beneath the ribs or in the upper abdomen, particularly with headache, visual changes, sudden swelling, nausea or feeling very unwell, because pre-eclampsia can present with upper abdominal pain. Prompt review is also appropriate for vomiting blood, black stools, difficulty swallowing or repeated vomiting.

Tell your clinician when the burning occurs, whether food sticks, and whether there is vomiting, upper abdominal tenderness or unintended weight loss. Ask which non-prescription products are suitable, how to separate them from iron or other tablets, and when persistent symptoms warrant a medication review or further investigation. If pain feels different from your usual reflux, describe its exact location and accompanying symptoms.