How to stop acid reflux in pregnancy?

That familiar, uncomfortable burning sensation rising up from your chest, often called heartburn, is a complaint that crosses the minds of many expectant mothers. It’s incredibly common, with some studies suggesting that up to half of all pregnant people experience some degree of acid reflux or indigestion. ^[1][8] This unwelcome side effect is usually a two-pronged assault: hormonal changes and physical space constraints. During pregnancy, the hormone progesterone relaxes smooth muscles throughout the body, including the lower esophageal sphincter (LES), which acts like a valve between your esophagus and stomach. ^[1][7] When this valve relaxes when it shouldn't, stomach acid splashes upward. ^[1][8] Add to that the growing uterus physically pressing upward on the stomach as the baby develops, and you have a perfect recipe for reflux, often starting around the second trimester. ^[1][7]

# Eating Habits

Changing how you eat can be just as important as what you eat when trying to manage stomach acid during this time. A major recommendation centers on portion control. Instead of sitting down for three large meals that completely fill the stomach, aim for five or six small, light meals distributed throughout the day. ^{[2][4][8][10]} When the stomach is less full, there is less internal pressure to force acid back up the esophagus. ^[4]

Another helpful strategy is to avoid skipping meals entirely. While it might seem counterintuitive, letting yourself get overly hungry often leads to eating too much, too fast, when you finally do sit down to eat, overwhelming the system. ^[4] Furthermore, try to give your digestive system ample time to process food before gravity stops cooperating. Try to finish your last substantial snack or meal at least three hours before lying down for the night. While some guidance suggests two hours, three hours provides a much safer buffer against nighttime reflux, especially as your physical capacity lessens later in pregnancy. ^[5] Chewing your food slowly and thoroughly can also aid digestion and reduce the amount of air swallowed, which can exacerbate symptoms. ^[2]

# Trigger Foods

Identifying and temporarily sidelining your personal acid culprits is a cornerstone of management. ^[1][10] While individual reactions vary, certain food groups are notorious for either increasing acid production or relaxing the LES further. ^[4]

Foods high in fat or grease should be cut back on, as they take longer to digest and can delay stomach emptying. ^[1][10] Spicy foods, which irritate the lining of the esophagus, are also frequent offenders. ^[1][4] Common culprits that often need to be reduced or eliminated include:

• Citrus Fruits and Juices: Oranges, lemons, limes, and grapefruit. ^[4][8]
• Tomato Products: Sauces, soups, and fresh tomatoes. ^[1][10]
• Chocolate: This is due to the fat content and the presence of theobromine, which can relax the LES. ^[1]
• Mint: Peppermint and spearmint, often associated with soothing digestion, paradoxically relax the sphincter muscle. ^[1][8]
• Onions and Garlic: These can be highly irritating to sensitive esophageal tissue. ^[1]
• Caffeine: This includes coffee, certain teas, and colas. ^[1][10]

Additionally, fizzy drinks should be approached with caution. While they don't necessarily cause acid production, the carbonation introduces gas into the stomach, which increases pressure and can physically push acid past the relaxed LES. ^[1][10]

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# Positioning Aids

Because the physical mechanics of reflux involve gravity, adjusting your position while resting is essential for obtaining relief, especially when symptoms strike at night. ^[7] Simply propping your head up with one or two pillows is often insufficient because it only bends your neck rather than lifting your entire upper torso. ^[1]

The most effective method is to elevate the entire head of your bed by about 6 to 9 inches. ^[1][7][10] This can be done safely using foam wedges designed for acid reflux or by placing sturdy blocks or risers securely under the posts at the head of the bed. ^[1] If elevating the whole bed isn't feasible, sleeping propped up semi-upright—using several pillows to support your back and shoulders—is the next best option to keep acid down. ^[7]

When you are resting or sleeping, try to position yourself on your left side. ^[7][10] There is anatomical reasoning behind this: the stomach is situated to the left of the esophagus, and gravity assists the digestive process when you are oriented this way. ^[7] Lying on the right side, conversely, may place more pressure on the stomach and make reflux more likely. ^[10]

# Physical Comfort

The pressure exerted on the abdomen from tight clothing can mimic the upward pressure from a growing uterus, forcing stomach contents upward. ^[4] This is a simple adjustment that offers immediate, though temporary, relief. Opt for loose-fitting, comfortable clothing, especially around the waistline. ^[4][10] This applies to tight waistbands on pants or restrictive shapewear.

When it comes to activity, staying active with gentle exercise, such as walking, is generally encouraged during pregnancy for overall well-being, but it is wise to avoid strenuous activity immediately following a meal. ^[4] Furthermore, staying upright—sitting or standing—for at least an hour after eating helps keep the contents where they belong. ^[4][10]

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# Medication Options

When dietary and physical adjustments only go so far, over-the-counter remedies can offer assistance, but always clear them with your obstetrician or midwife first. ^[4][7] Calcium carbonate antacids, such as those found in Tums, are frequently suggested because they are generally safe and can neutralize stomach acid effectively. ^[1][4][7]

However, caution is necessary with certain ingredients. Antacids containing sodium bicarbonate should generally be avoided, as they can lead to excessive fluid retention. ^[7] While many forms of magnesium are safe, some providers recommend limiting antacids high in magnesium later in pregnancy due to theoretical concerns about their effect on uterine muscle function, making the calcium-based options preferable initially. ^[1] If standard antacids are ineffective, your provider might discuss prescription-strength options like H2 blockers or proton pump inhibitors (PPIs), which reduce acid production rather than just neutralizing existing acid. ^[1][7]

# Final Considerations

While morning sickness tends to grab the headlines, persistent, painful reflux can significantly degrade the quality of life during the third trimester, often robbing expectant parents of precious sleep. ^[5] Understanding that this symptom often peaks when the baby is largest—and frequently resolves very quickly after delivery, sometimes within hours, as the mechanical pressure is instantly relieved—can be a powerful mental tool for enduring the final weeks.

It is important to know when simple home management is not enough. If heartburn becomes severe, wakes you up frequently, or is accompanied by other worrying symptoms like vomiting, difficulty swallowing, or weight loss, it requires professional evaluation. ^[3] Though rare, severe symptoms could indicate a different condition, like preeclampsia, which requires immediate medical attention. ^[3] For most women, however, persistent, manageable reflux is simply another temporary hurdle on the path to meeting their baby.