Heartburn in pregnancy: what eases it, which antacids to ask for, and when to worry

Heartburn and pregnancy go together for a lot of women. When it is mild, the NHS, the UK’s public health service, says changes to what you eat and how you live may be enough to control it. Here are four to try tonight.

1. Eat smaller meals more often, so your stomach is never very full.
2. Stop eating about three hours before bed.
3. Raise your head and shoulders on pillows when you lie down.
4. Try sleeping on your left side.

Here is why they help. In pregnancy, hormones slow the stomach down and the growing baby presses up on it, so a very full stomach is more likely to send acid back up towards your throat. Lying flat makes that easier, which is why heartburn often flares when you lie down at night.

If you still have heartburn after all four, ask a pharmacist about an antacid, which neutralises the acid, or an alginate, which stops the acid coming back up. The NHS lists both for heartburn in pregnancy. Tell the pharmacist you are pregnant.

KK Women’s and Children’s Hospital (KKH), in its guide to coping with common pregnancy symptoms, says heartburn that does not go away can sometimes be a sign of something more serious, such as pre-eclampsia, a pregnancy condition that causes high blood pressure. The signs to act on are further down this page.

What eases heartburn in pregnancy tonight?

Four changes: smaller meals, nothing to eat in the three hours before bed, your head and shoulders raised, and sleeping on your left side.

Smaller meals, more often

A very full stomach makes heartburn more likely. The NHS says in its advice on heartburn in pregnancy that you are more likely to get heartburn if you are very full, and that it can help to eat small meals often rather than larger meals three times a day. KKH gives the same first tip, small and frequent meals, and adds that a heavy meal can bring heartburn on by itself.

How you sit matters too. KKH says to sit up straight while eating and not to lie down straight after a meal. The NHS says the same, and gives the reason: sitting up during and just after a meal takes the pressure off your stomach.

The last three hours before bed

Three health services give this advice, each in its own words. KKH says to avoid eating just before bed.

HealthHub, Singapore’s public health information site, says in its A to Z of pregnancy health that you should avoid eating a few hours before bedtime. The NHS gives the clearest number: do not eat within three hours of going to bed.

If your dinner is late because of work, we’d make it the smaller meal of the day and have the bigger one at lunch. It is the same rule, moved to fit a Singapore working day.

Head up, and try your left side

HealthHub describes heartburn as a burning in the chest or an acidic feeling in the throat, especially when lying down, and its tip is to prop yourself up with pillows while you sleep. The NHS is more exact: propping your head and shoulders up can stop stomach acid coming up while you sleep, and sleeping on your left side can also help.

Naps count too. A KKH dietitian, giving diet tips for heartburn in pregnancy on HealthXchange, the health site of SingHealth, the hospital group KKH belongs to, says to avoid lying flat on your back after eating. If you are tired and need to lie down, prop yourself up with one or two pillows so you are not completely flat.

What to cut down on, and a glass of milk

Between them, KKH and the KKH dietitian name these triggers: oily, fried and spicy food, citrus fruits and juices, fizzy drinks, and drinks with caffeine, which in Singapore means kopi and teh as well as coffee. KKH also says to avoid any food or drink that you suspect gives you heartburn, which makes you the best judge of your own list. The NHS adds that smoking and alcohol can both cause heartburn, and that it is safest not to drink alcohol at all in pregnancy.

When heartburn starts, HealthHub suggests a glass of milk to ease it, and the KKH dietitian says milk may help ease the acidic feeling it brings. It is cheap and quick to try.

These changes are what hospitals tell you to try first, but the trial evidence for them is thin. Cochrane, the independent group that reviews trial evidence, says in its review of heartburn treatments in pregnancy that lifestyle changes are suggested for mild heartburn. None of the four small trials in that review compared the meal, timing or pillow advice with doing nothing.

Which heartburn medicines to ask a pharmacist about in Singapore

If the changes above are not enough, medicine is the next step. KKH says antacids may be prescribed to ease heartburn. The NHS says you can get some types from a pharmacist, and to tell them you are pregnant, because some antacids are not suitable in pregnancy.

The table below sets out what the NHS and two 2022 medical reviews say about each type: a review of reflux treatment in pregnancy in the journal Medicine, and a review of heartburn treatment in pregnant and breastfeeding women in the journal BMC Gastroenterology. Neither review is Singapore guidance, so treat the table as the list of questions to bring to the counter, not as a shopping list. The pharmacist checks the product in front of you.

Mind the gap between an antacid and your supplements. The NHS says not to take antacids within two hours of folic acid or iron, because antacids can stop your body absorbing them. If you are taking iron, our guide to iron needs in pregnancy covers the rest of that routine.

HSA found that the eight ranitidine brands contained traces of an impurity called NDMA above the level accepted internationally. NDMA is a contaminant that also turns up in tiny amounts in foods such as salted fish and pickled vegetables.

As a precaution, HSA stopped their sale and supply at clinics, hospitals and pharmacies on 16 September 2019. If an older article names ranitidine as the medicine to take, ask your doctor what to use instead.

How well does medicine work? Better than nothing, on the little evidence there is. Cochrane found four small trials with 358 women.

Women who took medicine reported complete relief from heartburn more often than women who had no treatment, a dummy pill, or diet and lifestyle advice, and Cochrane rated that evidence as moderate quality, which means fair but not strong. It also says there is not enough data to say which medicine is best, and that there are no large trials of heartburn relief in pregnancy.

Why pregnancy brings on heartburn, and when it eases

Heartburn is stomach acid coming back up into your gullet, the tube from your mouth to your stomach, which is why it burns in the chest or the throat. KKH describes burning pain or discomfort in the throat, chest or stomach, with a bitter taste in the mouth.

Pregnancy makes it more likely in two ways. Cochrane says pregnancy hormones affect the muscle that keeps food in the stomach, which lets acid come back up.

KKH says hormonal changes also slow down how fast the stomach empties, and that later in pregnancy the growing baby presses on your stomach. HealthHub puts the second part plainly: as the womb grows, it pushes on the stomach.

It is common, though the numbers do not agree. KKH says heartburn affects up to 60 to 80 per cent of pregnancies, which is six to eight in every ten.

A KKH dietitian quoted by HealthXchange gives a reported rate of 17 to 45 per cent, which is about one in six to nearly one in two. Both come from the same hospital group, so the safest reading is simply that it is common and you are far from alone.

On timing, the NHS says you can get it at any point in pregnancy, but it is more common from 12 weeks onwards, around the end of the first three months. It also says you are more likely to have it if you had heartburn before you were pregnant, if you have been pregnant before, or if you are in the later stages of pregnancy. If you are there now, our third trimester pregnancy guide covers the other changes of the last three months, and our pregnancy guides for every trimester cover the months before.

Heartburn in pregnancy usually stops after the birth. The 2022 review in BMC Gastroenterology says it typically settles after delivery, and that about 1 in 5 women still have it after giving birth. If yours carries on into the newborn weeks, raise it with your doctor, and say if you are breastfeeding, because that changes which medicines suit you.

On a doctor’s note or in a medical paper, you may see a longer name: gastro-oesophageal reflux disease, shortened to GORD (GERD in American spelling). Both 2022 reviews use it for heartburn in pregnancy.

The name sounds worse than the thing. Cochrane says heartburn in pregnancy can be frequent, severe and distressing, but serious complications are rare.

When it is not heartburn: the signs to act on

Most heartburn in pregnancy is exactly what it feels like, and it is uncomfortable rather than dangerous. KKH still lists three reasons to see a doctor about it: blood in your vomit, being unable to keep food and drink down, and heartburn that does not go away. On the last one, KKH says it may sometimes be a sign of something more serious, such as pre-eclampsia or heart disease.

Pre-eclampsia is a pregnancy condition that causes high blood pressure. The NHS says it is most likely from 20 weeks onwards, about halfway through pregnancy, though it can happen at any point in pregnancy, and sometimes in the days or weeks after the birth.

Its first signs are high blood pressure and protein in your urine, which you are unlikely to notice yourself. That is what the blood pressure and urine checks at your antenatal visits, the regular pregnancy check-ups, are looking for.

Two items on that list sit very close to ordinary heartburn: pain below the ribs, and heartburn that heartburn medicines do not ease. Either one on its own is on the NHS list. Get it checked straight away, not at your next appointment.

The stakes are real. The NHS, in its guide to pre-eclampsia, says most cases are not severe, but that it can lead to serious complications, including HELLP syndrome, which it describes as a rare liver and blood disorder.

The NHS also gives a separate, less urgent list. It says to see your doctor about heartburn if you have difficulty swallowing, a hoarse voice, a cough that does not get better, weight loss, or pain or swelling in your stomach.

Where to go in Singapore

For heartburn that is wearing you down but comes with none of the signs above, your gynae or your polyclinic doctor is the right first call. For the signs in the box, go now.

At KKH, as of October 2026, where you go depends on how far along you are. KKH says that if you are 22 weeks pregnant or more, with concerns such as leaking waters, bleeding or signs of labour, you should go straight to the Delivery Suite, the labour ward, at Level 2 of Women’s Tower.

Before 22 weeks, its Urgent O&G Centre, for obstetrics and gynaecology (the care of pregnancy and women’s health), is a 24-hour walk-in centre at Basement 1 of Women’s Tower. If you are booked at another hospital, call its delivery suite, or go to the nearest emergency department.

Your questions, answered

If you only do one thing tonight, eat a smaller dinner earlier and go to bed propped up. If heartburn keeps you awake most nights after these changes, ask your gynae or polyclinic doctor about a prescription medicine. If heartburn does not ease with heartburn medicines, or the pain sits below your ribs, or comes with a bad headache, blurred vision or sudden swelling, go to KK Women’s and Children’s Hospital (KKH) or the nearest emergency department now.

Wei Chun

Founder & Editor

A Singapore parent writing the guide he wished he'd had — practical, calm, and grounded in what actually works.

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