Many people experience heartburn during pregnancy. While Tums is a common treatment, people can also safely take other antacids, certain other medications, and make lifestyle changes for heartburn relief.

Heartburn is one of the main symptoms of gastroesophageal reflux disease (GERD), affecting up to 80% of pregnant people. There are many reasons why GERD is so common during pregnancy. For instance, hormones can slow digestion, making a person more prone to heartburn.

Along with hormonal changes, physical changes also play a role. There is more pressure on the stomach as the fetus grows, so heartburn tends to get worse in the second and third trimesters.

Read on to learn more about safe medications people can take for heartburn during pregnancy.

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There are different ways to safely manage heartburn during pregnancy.

Tums is one safe medication during pregnancy, but other medications and strategies can also provide relief.

Antacids

The first choice for heartburn medication in pregnancy is typically an antacid. Antacids contain a combination of calcium, magnesium, and aluminum salts that work by neutralizing stomach acid.

Antacids include Rolaids, Tums, and Mylanta.

These are generally considered safe, but people should pay attention to the dose. A pregnant person should not take more than 1,000 milligrams (mg) of elemental calcium daily from antacids and should avoid long-term use of antacids containing magnesium trisilicate.

Extended use is associated with several health problems.

Sucralfate

If antacids do not work, a doctor may recommend that a person try sucralfate. This medication forms a barrier in the stomach that helps block stomach acid from traveling up the esophagus.

Sucralfate is considered safe during pregnancy. In the United States, sucralfate is sold under the brand name Carafate.

Histamine-2 receptor agonists

The next medication to try is a class called histamine-2 receptor agonists (H2RAs). These help lower the amount of acid produced in the stomach.

This class includes the generic medications cimetidine, famotidine, nizatidine, and ranitidine. Brand names include Pepcid, Tagamet, and Zantac.

The Food and Drug Administration (FDA) removed ranitidine (Zantac) from the market in 2020. This was due to concerns about the presence of a possible cancer-causing substance in this product.

Proton pump inhibitors

Proton pump inhibitors (PPIs) are another medication used for heartburn. They are routinely prescribed for nonpregnant people to help manage heartburn.

PPIs include the following drugs:

  • dexlansoprazole
  • esomeprazole
  • lansoprazole
  • omeprazole
  • pantoprazole
  • rabeprazole

However, there may be some risks of PPI use in pregnancy. A large study found an increased risk of low birth weight, gestational diabetes, and preeclampsia with PPI use during pregnancy.

Despite this, a doctor may still prescribe a PPI to a pregnant person if the benefits outweigh the potential risks.

A note about sex and gender

Sex and gender exist on spectrums. This article will use the terms “male,” “female,” or both to refer to sex assigned at birth. Click here to learn more.

In 2009, a small study of pregnant women with heartburn explored whether acupuncture may improve heartburn. Participants of the study reported improvements in their sleep and eating, which are aspects of a person’s health often affected by heartburn. Participants also relied less on medication to manage heartburn.

However, acupuncture will not be right for everyone. If a person is considering acupuncture during pregnancy, it is important that they consult their doctor first.

Additionally, quince fruit extract has been used to treat digestive symptoms for generations.

A 2018 study in pregnant people showed that quince provided a similar level of heartburn relief compared with ranitidine (Zantac). Some people get relief from drinking milk or eating yogurt.

Probiotic supplements may be helpful.

A small 2012 study showed that a probiotic supplement improved constipation and reflux in pregnant people. More research is needed to determine whether probiotics should be recommended for heartburn and what types are best.

Several things beyond medication may help to manage heartburn. People can try:

  • avoiding lying down within 3 hours after eating
  • wearing loose-fitting clothing
  • eating small, frequent meals instead of fewer larger meals
  • limiting fluids with meals
  • eating slowly and chewing foods well
  • lying on the left side of the body to sleep or rest
  • elevating the head of the bed

Some foods are more likely to trigger heartburn. They include:

  • spicy foods
  • high fat foods
  • tomatoes, especially tomato sauce or tomato paste
  • high fat meats
  • citrus fruits and especially juices
  • carbonated drinks
  • chocolate
  • caffeinated drinks

Not everyone will experience heartburn after eating these foods. A person may consider keeping a food and symptom record to identify triggers.

If a person has made lifestyle changes to prevent heartburn but is still having heartburn, it is a good idea to talk with a doctor.

Additionally, if a person is taking medications and still not getting heartburn relief, contacting a doctor is a good idea. There may be changes in the dose, timing, or medication that can help.

Heartburn is very common during pregnancy. It can disrupt sleep and eating and generally affect quality of life.

There are many strategies to help prevent or manage heartburn, and some people may try medications.

If an antacid does not work, it is best for a person to discuss other options with their doctor to weigh the risks and benefits.