A Naturopathic Approach to Treating Heartburn in Pregnancy

Most pregnant women experience some degree of heartburn during their pregnancy, often towards the end when that sweet little baby is making its presence known!  For some, it’s a mild inconvenience after a large meal, for others it’s more bothersome making sleeping and eating an unpleasant chore.

Why am I getting heartburn?

Heartburn is extremely common in pregnancy.  Many – or most – women will get heartburn in the last trimester of pregnancy when the baby puts pressure on the stomach, which can cause the stomach contents to be pushed up the esophagus.

But some women can get heartburn even early on in pregnancy, as early as the first trimester.  This is because pregnancy hormones cause the digestive system to slow down.

Here’s a little lesson in anatomy: the esophagus connects to the stomach through an opening called the Lower Esophageal Sphincter (or LES).  The LES is supposed to be fully closed shortly after eating a meal. This keeps stomach acid (and all the food you’re digesting) in the stomach.  In pregnancy the muscles of the esophagus are more relaxed and contract more slowly.  This can allow stomach acid to come back up the esophagus, which causes the “burning” feeling that many women experience.

How can I treat heartburn in pregnancy?

In my practice, I try to work with food first, and then use herbs and supplements as needed to control this common pregnancy symptom.  I recommend using prescription acid-blockers as a last resort as they can interfere with the absorption of crucial vitamins and minerals including calcium, iron and B12, in addition to having a negative impact on our gut microbiota.

Diet

Eat small meals frequently.  Many Moms-to-be find that eating 4-6 smaller meals works better than 3 larger meals. Make sure to chew your food well – the enzymes present in saliva do their work! Don’t drink large quantities of fluids with meals.  Avoid greasy or fried foods, which trigger the body to make more stomach acid.   Make sure you are relaxed when you eat, which helps your body digest and helps that Lower Esophageal Sphincter close better.  I highly recommend finishing your meals with pineapple or papaya, which naturally contain digestive enzymes.

Some women can manage their symptoms by avoiding food triggers.  Make sure you can still eat enough calories to provide nutrients for your growing baby, though! These are the most common heartburn triggers:

• Coffee (and caffeine)
• Peppermint
• Citrus
• Tomato and spicy foods.
• Garlic or onions

Occasionally women have gluten or dairy sensitivities that make heartburn worse.

Herbs and Supplements

If the above dietary suggestions don’t work, talk to a Naturopathic Doctor about using herbs and other supplements to get your heartburn under control. There are a number of safe, effective options available for pregnant mothers, including deglycyrrhizinated licorice (DGL) and slippery elm powder.  Some women respond well to having a few sips of apple cider vinegar before meals. (But be careful, some women get worse!) Probiotics can be helpful for some patients, too.

Positioning

Avoid lying down after eating, and try sleeping on an angle (either with pillows or elevating your bed).

Most importantly, know that this pesky pregnancy will pass as soon as baby is born!