Yowsers! Am I having a heart attack?
Heartburn is incredibly common in pregnancy, especially in the 3rd trimester. It’s also known as acid reflux, or acid indigestion and is a result of acidic digestive juices coming up from the stomach, causing inflammation in the throat lining. Nice.
It’s both painful and uncomfortable but if the agony tends to strike after eating, you can be pretty sure it’s not a heart attack.
Heartburn tends to happen to mums-to-be, because the pregnancy hormone progesterone has a relaxing effect.
"Hormone changes allow the muscles in your body to relax to give room for the baby to grow but it also means that the sphincter at the top of the stomach relaxes, allowing stomach acid to rise up into your oesophagus," explains MFM’s GP, Dr Philippa Kaye.
"Pressure from the growing baby on your stomach also doesn’t help!"
Keen MFM forum visitor Gemlou was in agony with heartburn during her pregnancy, “It’s so bad that I could scream, it’s really awful… and really strong."
Argh! It’s getting worse! Why?
As your pregnancy develops you'll be more likely to get heartburn, particularly as your growing womb takes up more of your abdominal cavity, leaving less room for your stomach. You're quite likely to find that you feel full far more quickly, and that the upwards pressure from the womb can easily push gastric juices up into the throat.
It’s usually nothing to worry about and while some women can suffer for weeks, others find they may have just one or two bouts in a whole pregnancy, brought on by a particular food or drink.
How can I make sure I don't get it?
“Eat little and often, as food neutralises tummy acid,” says MFM midwife Ann Richley. “A glass of milk before bed, and peppermint tea after a meal, can help digestion. Sitting up straight helps – slouching can put pressure on your tummy. Propping yourself up with pillows when you go to bed lets gravity do its job as you snooze.” Sounds good...
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And try drinking a probiotic before your meal, which can help with digestion. Cut your food up into smaller pieces and chew longer and more slowly so you need less stomach acid to digest the food. Yes, it might make you feel like a 5 year old, but it may be the solution. And you can always think of it as practice!
It's common sense that as you lie down juices can flow more easily from the stomach up to the throat, so it's wise to leave plenty of time to digest properly before you go to bed at night. If you need a late-night snack to keep your energy up then opt for something that's very easily digested.
As for diet, soups, smoothies, yoghurt, milkshakes, protein shakes and puddings (yay!) are all good choices. Look for liquids that offer plenty of protein, such as milk and drinkable yoghurt, and aim to make solids a little less so: “chew solid foods slowly and extremely well, until they’re almost liquefied,” says Ann.
OK - well, what can’t I eat, then?
- Rich, heavy, spicy, fatty, creamy and sugary foods. (No takeaway curries.)
- Tomatoes (sauces) and onions (especially raw)
- Citrus fruit juices (and sometimes the fruits themselves) e.g. orange, lemon and grapefruit
- Sour fruits (like cranberry), as well as some berries
- Alcohol, caffeine and fizzy drinks
Leah, 39, mum to Ty, 9 and Thea, 5, says, “I didn’t drink very much at all with either of my pregnancies, but there were special occasions, like weddings and us announcing the pregnancies, when I wanted to at least have a sip of something posh – but I couldn’t! Even just one mouthful of sparkling wine would give me heartburn. If I got it with any drink or food I’d just had, the only thing that worked for me was a glass of water or milk, to make me feel better.”
Is there anything else that can help?
Probiotic products can help improve your digestion, and so lessen the pressure that can cause heartburn, by improving the balance of bacteria in the digestive tract. If you find dairy products are usually a heartburn trigger for you then look for a non-dairy source of probiotics, such as those in capsule or powder form.
“I found Gaviscon is really good and fast, but a milk drink does help as well if you don't have any tablets,” says MFMer Ivana. “Gaviscon is perfectly safe in pregnancy,” she adds.
And a nice little tip from an MFM fan (and mother of 4), is to try the childhood sweets, Refreshers. “Great for heartburn!” she laughs, knowing that those horrible heartburn days are well behind her.
But what if it won’t go away?
Time to talk to your midwife! Prescription medication for heartburn is generally OK during pregnancy. A study in Denmark found that heartburn drugs, known as PPIs that contain omeprazole, lansoprazole and esomeprazole, when prescribed to mums-to-be for severe heartburn were found to cause no increased risk of birth defects.
One mum, MrsW272I, says, “I was put onto Omeprazole, which is safe during pregnancy. I have found that I've had awful bouts of acid reflux whilst pregnant and the Gaviscon liquid helps me but Rennies don’t.”
Drugs such as nitidine - often known as Zantac - are also considered safe for use in pregnancy. Also Ranitidine, used to treat ulcers of the stomach and intestines, can be taken for heartburn and indigestion during pregnancy if other treatments have not worked.
So just when you thought you could eat Indian takeaways for 9 months straight, there we go, raining on your parade again. Well what can we say? Except it's all part of the service, Ladies - and you're welcome!
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