Burning Desires

If pregnancy is giving you heartburn, you want it to stop, now. Here are five ways to extinguish the fire

It was heartburn

That got me in the end. I could take the swelling, the back pain, the constant trips to the bathroom, the itchy skin, the fatigue, the sweating, the sleep­lessness and even the psychological shock of seeing the scale tip 200 pounds. But the constant, searing pain of heartburn made the miracle of pregnancy seem more like a curse—by the middle of my third trimester, my mantra had changed from Please, let him be healthy! To Just get him OUT!

That fiery sensation known as heartburn happens when the lower esophageal sphincter (LES), a muscle respon­sible for keeping stomach contents in their place, begins to relax or leak. This allows stomach acids to flow upward into the esophagus, explains Suzanne Trupin, M.D., CEO of Women’s Health Practice of Champaign, 111. Pregnant women are prime candidates for two reasons: First, the hormone relax in—busy limbering up your joints and con­nective tissue for an easier delivery—slows your digestion, meaning food stays in your stomach longer and triggers more acid production. Second, your growing baby exerts pressure on both the stomach and the LES, increasing the chance that acids will be pushed up into the esophagus.

So what’s an expectant mother to do? Follow these five tips to relieve the pain:

1.    Eat less, more often

Overeating exacerbates heartburn, says Rachel Brandeis, M.S., a registered dietitian in Atlanta who specializes in pre­natal nutrition. “When you’re pregnant, there’s less room for your stomach to expand,” she explains. And maintaining a sensible diet will not only stave off heartburn in the short term, but throughout your pregnancy as well, because gain­ing more than the recommended weight puts more pres­sure on your abdomen, which can trigger the condition.

Instead of three meals a day, aim for six mini-meals of no more than 1’/2 cups of food each, Brandeis recommends. Smaller meals are easier for your body to digest. (See “Mini­size Me,” pg. 48, for a sample days’ worth of teeny meals.)

2.    I eliminate trigger foods

Identify the foods that intensify your heartburn and ban­ish them from your diet. While there are no universally “banned” foods, common heartburn triggers include acidic foods, such as citrus fruits and tomatoes, greasy or fried foods, spicy foods, chocolate, coffee and carbon­ated beverages and alcohol (which, as you well know, you should eliminate anyway!).

Food guide pyramid. For pregnant women

3.    I focus on fluids

“Liquid-y foods are less likely to cause problems than sol­ids, since they move through the stomach more quickly,” Brandeis says. Soups, smoothies, yogurt, milkshakes, protein shakes and puddings are good choices. Look for liquids that offer plenty of protein, such as milk and drinkable yogurt. And aim to make solids a little less so: “Chew solid foods slowly and extremely well, until they’re almost liquefied,” Brandeis adds.

4.    Sleep smart To avoid nighttime heartburn, don’t eat anything for at least three hours before bedtime. Elevate the head of your bed by placing books under the legs, and if you’re not already sleep­ing on your left side, start now; stom­ach acids will have to travel uphill to reach the esophagus—no easy feat!

5.    Time for Turns

It’s fine to find relief in a bottle of Turns or Rolaids or other calcium- containing antacids. However, “too much calcium can block iron absorp­tion, so don’t take Turns at the same time you take your prenatal vitamin,” Brandeis advises. By the time I gave birth, I estimate I’d ingested my own considerable body weight in Turns. This overuse created calcium over­load, which may have exacerbated my anemia. If you’re reaching for the ant­ acids 10 times a day (or more—as was), talk to your doctor: She may want to check for ulcers or a hiatal hernia (where part of the stomach protrudes into the chest cavity), or prescribe medication.

Also, avoid antacids that list aluminum (such as aluminum hydroxide or aluminum carbonate) as an ingredient; it can cause constipa­tion and can even be toxic in large doses. Remedies containing aspirin (such as Alka-Seltzer) should also be avoided during pregnancy; look for salicylate or acetylsalicylic acid in ingredients lists. You don’t want an antacid containing sodium bicarbon­ate (baking soda) or sodium citrate, either. Both are high in sodium, which causes water retention.