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HEARTBURN RELIEF SUGGESTIONS
Note: More than one-half of all pregnant women report symptoms of severe heartburn, particularly during their second and third trimesters. Not all heartburn remedies will work for everyone. You may have to try more than one or a few remedies to find one that works for you. Sometimes a woman may have to "ride it out" until after the baby is born to find relief. As always, check with your midwife or health care provider before trying any methods or heartburn treatments. Here are some recommendations and suggestions of various heartburn prevention and relief methods that work for most pregnant women and are considered safe to use:
Avoid bending over, especially after eating. Bend at the knees instead of at the waist.
Don't wear tight girdles or belts. Wear loose, comfortable clothing. Avoid any tightness around your waist and tummy.
Place books or blocks under the head of your bed to raise it about 4 inches. Sleep propped up with several pillows or a wedge. Elevating your upper body will help keep your stomach acids where they belong and will aid in your digestion.
Bed Wedge, 22° Lift, 24 inch x 24 inch x 10 inch
Bed Wedge, 26° Lift, 24 inch x 24 inch x 12 inch
The Bed Wedge can elevate the upper body or legs and helps treat the symptoms of hiatal hernia and acid reflux disorders.
Don't smoke. Smoking increases stomach acidity.
Gain a sensible amount of weight during pregnancy and try to stay within the guidelines your health care provider or midwife suggests.
Avoid drinking large quantities of fluids during meals. You don't want to distend your stomach. It is important that you DO drink 8 to 10 glasses of water daily during pregnancy, but sip it between meals.
Try chewing gum after eating. Chewing gum stimulates your salivary glands, and saliva can help neutralize acid.
MEDICATION
While medication is usually not necessary for this disorder, in severe cases it may be of benefit. The medicines most frequently used include antacids and H2 blockers (acid reduction drugs, such as Tagamet, Zantac, and Pepcid). These drugs should be used only with your midwife's or health care provider's approval. As long as you can live with the symptoms, endure the discomfort without drugs or medicines.
An over-the-counter antacid that contains magnesium or calcium carbonate may ease discomfort, but check with your midwife or health care provider before taking one. Some antacid brands contain aluminum or aspirin or are high in sodium.
OVER-THE-COUNTER ANTACIDS
As always, before taking any medication of any kind, check with your midwife or health care provider.
Your first choice of OTC antacids should probably be chewable antacids made from calcium carbonate (sometimes just called "calcium" on the label). Fast, portable, and effective, they may be all you need. Some of them even taste pretty good.
Antacids containing magnesium hydroxide or magnesium oxide are also a good choice and come in tablet or liquid form. But bear in mind that swallowing any liquid, even the liquid you need to swallow a tablet, will cause your stomach to do what it does naturally - produce digestive juices, including acid, the very thing you're trying to reduce. So it's best to swallow tablets with as little liquid as possible when you're having trouble with heartburn.
All of these medicines are true antacids. That is, they neutralize the acid that's already in your stomach and causing you pain. Chewable and liquid antacids act much faster than tablets you swallow because you don't have to wait for them to dissolve. You can experiment and see which type works most effectively for you.
Avoid antacids that list "aluminum" (such as aluminum hydroxide or aluminum carbonate) as an ingredient. Aluminum can be constipating and, in large doses, toxic. So even though it's probably safe when used occasionally at the recommended dosage, it's not your best choice and should be avoided if possible.
Remedies containing aspirin (such as Alka-Seltzer) should also be avoided during pregnancy. Aspirin may be listed on a label as salicylate or acetylsalicylic acid. Aspirin acts as a blood thinning agent and should be avoided during pregnancy since it can cause bleeding problems at the time you give birth.
In addition, avoid sodium bicarbonate - commonly found in the form of baking soda, but also sold as an antacid in tablet form - and sodium citrate. These are high in sodium, which causes you to retain water. And if you're far enough along in your pregnancy to have gone into a panic trying to remove rings from your swollen fingers or looked down in horror at your puffy ankles, you'll understand why that's the last thing you want right now.
Remember that even the chewable antacids that come in yummy fruit flavors are medicines. If you find yourself popping more of them than recommended, you may want to ask your midwife or health care provider about using something more effective and longer lasting, usually called an "acid reducer." Instead of neutralizing your stomach acid like the antacids, these actually stop your stomach from producing most of the acid it normally would.
If you take a pure acid reducer, it works best when taken before a meal because it won't help with the acid already in your stomach. Some of these medications are a combination of an acid reducer (such as famotidine) and an antacid (such as calcium carbonate or magnesium hydroxide), to provide immediate relief from the acid that's already distressing you and to reduce further acid production for up to 12 hours.
WARNING! There are no drugs that have been proven absolutely safe for your developing baby. Use extreme caution in taking any medications during pregnancy and then these should only be used after all other methods have been tried and with the careful guidance of your midwife or health care provider.
Adid Redux, NOW Foods, 90 Lozenges - Acid Redux is a unique proprietary formulation of acid buffering agents that can be helpful in the alleviation of occasional acid indigestion. Acid Redux is an all-natural dietary supplement. Acid Redux contains natural, low-lead, USP-grade calcium carbonate, as well as small amounts of vitamin D, neutralized vitamin C, magnesium and potassium. Vitamin D is included to assist calcium absorption, and studies show that many people with acidity problems are vitamin C deficient. This all-natural dietary supplement is specially formulated to help those with too much acid in their body. Acid Redux mint-flavored lozenges contain no artificial flavors or colors.
AlkaMax, Natural Antacid & Alkaline Booster, 200 g,, Powder - AlkaMax addresses acidic conditions by using powerful alkaloid minerals that convert potential hydrogen back into a state of alkalinity at the cellular level without eliminating the healthy acid that your body needs for digestion. Warning: This product contains potassium which may interfere with certain types of heart medications and diuretics. Those individuals should use this product only under the supervision of a medical professional.
Heartburn / Gastroesophageal Reflux Supplements - Information & Products
ACTIVITY
Stay active. Avoid abdominal exercises that require bending. Bend at the knees, not the waist. Watch your posture, do not slump while sitting since this puts extra pressure on the belly (it also contributes to a higher incidence of "posterior presentation" births). Limit your time in "bucket seats" in automobiles while traveling, taking frequent "stretching" breaks.
DIET
NUTRITION
Nutrition plays an important role in stopping the symptoms of heartburn. Be sure to include these recommendations in addition to the other lifestyle changes that are recommended above under Conventional Medical Treatment.
- At the first sign of heartburn, drink a large glass of water. This often helps.
- Try raw potato juice. Do not peel the potato, just wash it and put it in your juicer. See Juicing for more information. Mix the juice with an equal amount of water. Drink it immediately after preparation, three times a day.
- Change your eating habits. Eat more raw vegetables. Chew your food well. Eat slowly and enjoy your food. Follow a proper diet with plenty of lean protein to support your lean muscles and organs.
- Eat small, frequent meals throughout the day. Breaking your 3 large meals a day into 6 smaller meals (about half the size you would normally eat at a regular meal) will not only help with heartburn problems but will help curb hunger pangs and keep your blood sugar on a more even level. Avoid eating big meals. Again, take your time eating and chew your food thoroughly.
- Avoid very hot or very cold beverages. Avoid drinking large quantities of fluid with your meals. Instead sip them throughout the day between your meals.
- Sip 1 tablespoon of raw apple cider vinegar, mixed with a glass of water, while eating a meal. Do not drink any other liquids with meals.
- Eat fresh papaya and/or fresh pineapple to aid digestion. Chew a few of the papaya seeds as well. Papaya Enzyme chewable tablets can be a substitute for fresh papaya. See recommended products under "Nutrients" below.
- Do not eat for three hours before bedtime. Wait at least three hours after eating before lying down.
- Do not consume carbonated beverages, fats, fried foods, processed foods, sugar, or spicy or highly seasoned foods. These seem to be the main cause of heartburn.
- Do not take a multi-enzyme complex containing hydrochloric acid (HCl).
- Avoid a diet high in refined sugar. A diet high in sugar makes heartburn worse. It irritates the lining of the esophagus and stomach and increases stomach acid, fermentation of the sugar produces more stomach gas, and a high sugar content encourages the growth of certain stomach bacteria that recent medical studies say may cause chronic stomach ulcers. Eliminate or sharply curtail your intake of sugar, corn syrup, high-fructose corn syrup, molasses, and all food products made with them.
- Avoid alcohol. Alcohol should be avoided during pregnancy for other reasons besides heartburn. Alcohol, like sugar, has a directly hostile effect on the stomach lining and also stimulates increased stomach acid, but it has the added negative effect of weakening the muscular sphincter at the end of the esophagus, making reflux of stomach acid into the esophagus more likely. Eliminate or sharply curtail your intake of alcoholic beverages.
MoonDragon's Pregnancy Information: Alcohol & Pregnancy
- Avoid chocolate, coffee and other caffeine containing products. Similarly, Chocolate produces an almost immediate weakening. The caffeine-like substance in chocolate seems to be the culprit in causing the problems. Substitute carob for chocolate, if possible. Coffee may also increase the output of stomach acid, try to reduce or eliminate drinking too much coffee.
- Eating a fatty meal causes a digestive response, allowing easy access for stomach acid into the esophagus. Try to limit the fat content of your foods to 30% of your total calories per day and to spread those fat calories out throughout the day as much as possible.
- Milk, although you might think of it as a food to soothe the "angry" stomach, actually has only a temporary neutralizing effect on stomach acid, followed later by a rise in stomach acid to an even higher level than it had been. A bite or two of cottage cheese, taken when you feel heartburn coming on, may help to ease it away. Try mixing a little honey in with your milk, which can also ease the burn and discomfort of heartburn.
Plain, unsweetened Yogurt may be helpful. Yogurt is not only nutritious, providing needed calcium, but it also provides active "friendly bacteria" cultures, which helps to keep your intestinal tract healthy and functioning properly. The yogurt you choose should contain active cultures.
Milk is NOT a heartburn remedy! If you have problems with lactose intolerance (caused by an absence of an enzyme that breaks down lactose found in dairy products), drinking milk can aggravate your gastric system. You can take a "lact-aid" enzyme supplement to help with mild lactose intolerance.
Lactase Enzyme, Lactase Formula, EnzymeActive, Nature's Way, 230 mg, 100 Caps - Lactase Enzymes are a dietary supplement which supports the digestion of lactose rich foods. Lactase Enzymes are especially useful for those with lactose intolerance, but is also helpful for any lover of dairy products. Recommendation: For individuals with lactose intolerance or difficulty in digesting dairy products. Take three capsules as needed just prior to ingesting foods or beverages containing dairy products or lactose. Take one capsule if you are taking medications or vitamins containing lactose.
- Orange juice also causes problems in some people, because it is naturally acidic. Limit or eliminate citrus juices if they cause problems with your digestion.
- Avoid highly seasoned food. Spicy foods, especially those made with hot peppers or pepper, contain corrosive acids that directly irritate the stomach, contribute to heartburn. Try to avoid eating chili peppers, jalapenos, or other hot spices if they typically cause heartburn for you. Avoid black pepper. This is a natural irritant.
- Tomato products, such as juices, pastes, salsa and sauces (including marinara sauce and ketchup), may irritate the stomach and esophagus lining directly and may also cause heartburn for some people. If you like to grow your own tomatoes, there are some varieties that are naturally low in acid.
- See Fasting for instructions (fasting is not recommended during pregnancy). Also see the self-tests under Acidosis and Cardiovascular Disease.
HERBS
Always check with your health care provider or midwife before using herbal therapy or nutritional supplements during pregnancy. There are some herbs that should be avoided during pregnancy and lactation and other herbs and supplements should be used under supervision with proper dosages. The suggestions below are for "general population" heartburn and not necessarily "pregnancy specific." A general rule of thumb when it comes to any herb or supplement is "moderation" and only use enough to relieve the ailment.
- Aloe vera juice aids healing of the intestinal tract. Some people drinking aloe vera juice may find that it may act as a laxative in some individuals. See recommended products under "Nutrients" below.
- Catnip, fennel, ginger, marshmallow root, and papaya tea all aid in the proper digestion and act as a buffer to stop heartburn.
- Gastritix Formula W/ Chamomile, Nature's Way, 474 mg, 100 Caps - Promotes a calming effect on the digestive tract. This formula contains chamomile, to promote normal tone in the digestive tract. Ginger Root, an aromatic bitter that stimulates digestion to promote gastrointestinal comfort. Fennel Seed, used traditionally to sweeten the breath and support digestion. Slippery Elm Bark and Marshmallow Root, traditionally used for their soothing and emollient effects on the digestive tract. Recommended dosage: Take 2 capsules with meals as needed.
- Enjoy a cup of Chamomile herbal tea. Chamomile's soothing qualities make it a wonderful treatment for heartburn and stomach upset by relieving esophageal irritation. Caution: Do not use chamomile if you have an allergy to ragweed. Do not use chamomile on an ongoing basis, as ragweed allergy may result. Do not use chamomile oil during pregnancy since the oil is a very potent uterine stimulant. It can be used safely in dried or fresh herb form as a tea.
- Calming Tea with Organic Chamomile for Daily Stress Relief, Yogi Tea, Caffeine Free, Certified Organic, 16 Tea Bags - Calming Tea by Yogi Tea is a safe and time-tested Ayurvedic formula designed to ease stress and tension, encouraging a state of relaxed alertness without drowsiness. This blend contains several herbs that are helpful for the relief of heartburn.
- Chamomile Tea, Caffeine Free, Yogi Tea, Certified Organic, 16 Tea Bags - This is pure, organic chamomile tea with no other added herbs. It is a well-known relaxant to relieve occasional sleeplessness, anxiety, as well as an antispasmodic for minor menstrual cramps and stomach discomfort.
- Licorice reduces the production of stomach acid which also decreases heartburn. Caution: Can have some negative side effects, such as constipation, headache, sodium and water retention, loss of potassium, and high blood pressure. Do not take licorice if you have high blood pressure. Moderate use of licorice may be used if you are pregnant and you don't have problems with high blood pressure. Consult with your midwife before using it as a heartburn remedy.
- To reduce gas, take cardamom or cinnamon. Use cinnamon in moderation during pregnancy. It is a uterine stimulant when used in high doses, but moderate culinary use is acceptable. Do not take it in essential oil form.
- Dill soothes the digestive tract. Crushed seeds are best. Use in a salad dressing or in other recipes for cooking. Caution: Use moderately if you are pregnant.
HERBS THAT MAY CAUSE HEARTBURN IN SOME PREGNANT WOMEN
- The use of chili may lead to heartburn when taken in high doses, but moderate culinary use is acceptable for use during pregnancy if it doesn't bother you. It may flavor breast milk in women who breast feed.
- Garlic may lead to heartburn when taken in high doses. It can flavor breast milk. Moderate culinary use is acceptable in pregnancy as long as it doesn't bother you.
- If peppermint you causes heartburn, avoid its use. Many people find it helpful for digestion and gastric problems. Peppermint is a uterine stimulant. Avoid oil completely during pregnancy. The dried herb is safe in cooking and can be used as a tea if you have problems with morning sickness or nausea. If peppermint bothers you, use catnip instead. It is a member of the mint family with similar soothing capabilities, but it is less intense and is safe for women, children and babies (favorite midwives's remedy for infant colic).
NUTRIENTS Supplement Suggested Dosage Comments Very Important Aloe vera As directed on label. Aids healing of the intestinal tract. Aloe Vera Gel & Juice, 99.7% Pure, Certified Organic, Nature's Way, 1 Liter Pancreatin
Plus
BromelainAs directed on label. Take with meals. Enzymes necessary for proper digestion. Super Digestive Enzymes w/ Pancreatin, Bromelain & Other Digestive Enzymes, 90 Caps Papaya Tablets As directed on label. To relieve symptoms. Use chewable tablets form. Papaya Enzyme W/ Mint & Chlorophyll, Chewable, NOW Foods, 23 mg, 360 Lozenges Vitamin B complex
Plus Extra
Vitamin B-1250 mg 3 times daily, with meals
200 mcg 3 times daily.Needed for proper digestion.
Use a lozenge or sublingual form. Ultimate B Complex Formula, Nature's Secret, 60 Tabs, Ultra B-12, NOW Foods, 4 oz.Helpful Acid-Ease, from Prevail As directed on label. A soothing plant-enzyme and herb formula that aids in the breakdown and assimilation of foods. Digest Ease, Acid Neutralizer, Promotes Healthy Digestion, Banyan Botanicals, 90 Tabs Lactobacillus Acidophilus 1 to 3 capsules with each meal. A digestive aid that helps maintain intestinal flora. Primadophilus Optima, 35 Billion CFU, Nature's Way, 60 Vcaps Digestive Enzyme Combination 1 capsule with each meal. A digestive aid that helps promote better digestion. Avoid any complex that contains hydrochloric acid (HCl). Digestion Supplement w/ Enzymes, Nature's Way, 530 mg, 100 Caps MSM (Methylsulfonylmethane) Mix with your favorite juice or take alone. 1 to 2 teaspoons once or twice daily. MSM relieves hyperacidity without disturbing the normal acid-alkaline balance. MSM (Methylsulfonylmethane) Liquid, Pure Lignisul, 16 fl. oz.
NOTIFY YOUR MIDWIFE OR HEALTH CARE PROVIDER IF...
You or a family member has symptoms of heartburn during pregnancy. This should be diagnosed.
The following occur after diagnosis:
- Simple measures don't bring relief.
- You begin vomiting late in pregnancy.
- You vomit material that has blood in it or looks like coffee grounds.
- You have black or tarry stools.
You should check in with your health care provider or midwife if none of these suggestions helps your heartburn.
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