There are two primary reasons why heartburn seems to oh-so-viciously attack during pregnancy:
1) Hormonal changes, which slow down normal digestion. This altered digestion often leads to many symptoms of indigestion: bloating, gas, constipation, and reflux (heartburn).
2) A growing uterus, which puts pressure on the stomach, diaphragm and esophagus, and causes internal organs to be a bit "rearranged" and shifted from their usual positions. For many women, this begins as early as later in the first trimester, when the uterus really begins to pop up and out. For others, the heartburn doesn't hit until sometime in third trimester, when a very bulging belly begins to really put the pressure on.
Whatever the reason for your heartburn, it's certainly never comfortable. Praise God that is is only for a season, it's for a very worthwhile reason, and there are many ways to help relieve the discomfort! Here are a few of the tips and tricks that I have learned for dealing with it:
** Eat smaller meals. I have to admit, my tendency isn't to do this, because as long as I kept on eating the heartburn temporarily goes on hiatus. It returned within about 5 minutes of finishing, which made overeating a real temptation. However, when I do eat smaller meals and snacks, spaced well throughout the day, I often find that the heartburn doesn't hit as hard or last as long.
** Prop up with pillows. My chiropractor would disown me for putting this in print, although I'm pretty sure most heartburn sufferers end up going this route anyways. For my entire first trimester, up until about 2 weeks ago, I slept with double the usual pillows under my head. It didn't completely deal with the issue, but it did make falling asleep that much easier, as being upright helps to lessen heartburn at night. Know that it might throw your neck and back out somewhat (I eventually ended up with a string of bad headaches and a chiropractor's visit), but it was worthwhile during that short season.
** Avoid trigger foods. The main ones I know of are caffeine, coffee (even decaf- it's the acidity), black tea, tomato, and spicy foods. I also found that sugar and sweeteners exacerbated it, and sometimes so did citrus fruits and juice. I couldn't even drink my coffee alternatives (grain "coffees", like Teeccino and Inka), because they seemed to have the same effect. This was the first pregnancy that I was particularly vigilant and aware of this trigger, and I noticed a huge increase in heartburn each time I cheated with a food or drink that I knew might bring it on. I quickly learned my lesson!
** Digestive enzymes. This was a great discovery this pregnancy! I went to the health food store in search of slippery elm lozenges (see below), and they were out, but in talking with a staff member there, I realized just how helpful digestive enzymes could be. If your heartburn is caused by the digestive disruption of early pregnancy, or because a crowded stomach is just not digesting food sufficiently, I would highly recommend giving these a try! Try to find one with a broad range of enzymes (for digesting protein, carbohydrates, fats, etc.) as well as with some HCL (hydrochloric acid). If you can't afford the more expensive ones, even a simple Papaya Enzyme will help somewhat and these can be found very cheaply even at grocery store pharmacies. Another inexpensive option is to drink some water with a bit of fresh lemon juice or apple cider vinegar, or a small glass of kombucha or kefir, before eating (the enzymes and good bacteria will assist in promoting better digestion).
** Avoid beverages with meals. It is best to avoid drinking anything at least 15 minutes before meals, and for at least 30 minutes after meals. The reason is that the hydrochloric acid in your stomach becomes watered down, and as a weaker acid, it is less able to do the hard work of digesting food fully and quickly. When food is not digested well or is allowed to sit and begin to ferment, indigestion results.
** Drink Ginger Tea. One of my favorite and most effective ways of dealing with indigestion/heartburn is by sipping on real ginger tea a little while after a meal. By real, I mean either fresh, grated ginger that has steeped in boiling water, or else a tea like Traditional Medicinal Organic Ginger Tea (which is just high quality dried ginger in a tea bag, essentially). This pregnancy, hot teas didn't sit so well with me, so sometimes I did better by cooling off my tea with ice before I drank it.
** Use slippery elm lozenges.Though they are primarily used for sore throats, colds, etc. as a natural alternative to cough drops, I discovered by accident that they are incredibly helpful for soothing heartburn symptoms! Perhaps because they coat the throat and esophagus, but whatever the reason, I always like to keep a box of them on hand. Most health food stores carry the only brand I have ever seen, which is Thayers Slipper Elm Lozenge, or they can easily be ordered online. My favorite is cherry. :)
** Try foods that minimize acid. There are some foods that seem to help absorb excess acid and minimize gastric reflux. Here are a few that I know of: bread or crackers, popcorn (bread, crackers and popcorn should be eaten plain), milk, yogurt and raw almonds. I didn't find that these always worked, and sometimes one wouldn't work but another would. However, it is worth it to try out some different foods to see how they affect you, and then try to keep some of those things around the house, on your nighttable or in your purse. I know my husband finds plain popcorn extrememly helpful when he gets heartburn, and I find raw almonds and raw milk help a little bit, as do crackers sometimes.
** Get your water in when you can. I'm not sure how common this is, but I had a hard time staying hydrated through first trimester, because the heartburn would flare up again every time I took a few sips of water. It got to the point where I developed an aversion to drinking anything, leaving me chronically dehydrated, which resulted in other issues. I found the easiest time to get my drinking in was in the morning, when I first got up. Somehow my digestive system managed to calm down overnight, and those early hours were the easiest for getting in fluids. If you are struggling like this, try your best to find a time of day when you can consume extra liquids, to help make up for what you are lacking in the rest of the day. Other options for staying hydrated include eating fresh fruits and veggies when you snack (for their high water content), sucking on fruit juice popsicles, making smoothies for meals, or serving soups frequently.
Are any other pregnant mamas out there struggling with this issue? How do you cope with heartburn during pregnancy? Share your strategies with us!