Heartburn and Acidity in Pregnancy: Why It Gets Worse at Night and What Actually Helps

If you are lying in bed at night and feeling like your chest is on fire or if you can no longer eat a full plate of dal-chawal without feeling like it is coming back up, welcome to pregnancy heartburn. It is extremely common, extremely annoying, and entirely manageable.

Let us understand why it happens and most importantly what you can safely do about it.

Why does acidity and heartburn get worse during pregnancy?

There are two main reasons, and both are completely pregnancy-specific:

Progesterone relaxes everything including the valve that should stop acid

The valve between your oesophagus (food pipe) and stomach is called the lower oesophageal sphincter. It normally stays closed after eating to prevent stomach acid from coming back up. Progesterone which is very high during pregnancy relaxes smooth muscle throughout the body, including this valve. With a relaxed valve, stomach acid can easily travel upward, causing that burning sensation in your chest and throat.

Your growing uterus pushes upward

As your baby grows, your uterus presses upward on your stomach. This compresses the stomach, making it harder for it to process food efficiently, and increases the likelihood of acid reflux. This is why heartburn tends to worsen as pregnancy progresses and is often at its worst in the third trimester.

Source: ACOG – Gastrointestinal Issues in Pregnancy | Cleveland Clinic Pregnancy Heartburn

What does pregnancy heartburn feel like?

• A burning sensation in the chest or upper abdomen, especially after eating
• A sour or bitter taste at the back of the throat
• Discomfort or pain when lying down or bending over
• The feeling that food is "coming back up"
• Worse at night particularly after dinner

Pregnancy acidity relief Indian home remedies that work

Before reaching for medication, try these tried-and-tested approaches:

Eat smaller, more frequent meals

This is the single most effective change. A stomach that is not overfull has less acid to push upward. Eat 5-6 small meals instead of 3 large ones. Avoid eating to full capacity in any single sitting.

Indian kitchen remedies

• Cold milk or chilled buttermilk (chaas): One of the most effective home remedies for pregnancy acidity. Cold milk neutralises stomach acid quickly. Sip slowly rather than drinking a large glass quickly.
• Coconut water: Mildly alkaline, naturally cooling, and easy on the stomach excellent for pregnancy acidity.
• Mulethi (liquorice root) tea: Has a long Ayurvedic history for digestive complaints. Safe in small amounts during pregnancy. Boil a small piece in water and sip.
• Sabja seeds (basil seeds/tukmaria): Soaked in water, these form a gel that coats and soothes the digestive tract. Very commonly used in India for acidity safe in pregnancy.
• Banana: Naturally alkaline, coats the oesophagus and neutralises excess acid. An excellent pre-meal snack.
• Aam panna made with less sugar: Raw mango concentrate cold and slightly cooling to the digestive system.

Source: ICMR Dietary Guidelines | Ayurvedic Pharmacopoeia of India for Digestive Issues

Lifestyle adjustments that reduce acidity

• Sleep with your head and upper body elevated prop pillows under your upper back, not just your head
• Do not lie down for at least 2-3 hours after eating
• Wear loose, comfortable clothing tight clothing around the abdomen increases pressure
• Avoid spicy, oily, fried, and acidic foods (tomatoes, citrus, tamarind) in the evenings
• Avoid carbonated drinks, strong chai or coffee, and chocolate

Safe antacids during pregnancy in India

If home remedies do not provide sufficient relief, some antacids are considered safe during pregnancy. However, always consult your doctor before taking any medication:

• Calcium carbonate-based antacids (like Digene gel, Gelusil): Generally considered safe when used occasionally
• Sodium bicarbonate (soda bicarb): Not recommended during pregnancy can cause water retention
• H2 blockers (ranitidine-based): Discuss with your doctor some are used under medical supervision in pregnancy
• Proton pump inhibitors (omeprazole, pantoprazole): Only under doctor's prescription during pregnancy

Important: Do not take antacids without your doctor's guidance. Some contain aluminium or magnesium in doses that may not be appropriate for regular use in pregnancy.

Source: FOGSI – Safe Medications in Pregnancy | ACOG Practice Bulletin on Gastrointestinal Issues in Pregnancy