Saturday, January 25, 2014

Goodness, Gracious, Great Balls of Fire! Heartburn in Pregnancy

So I wanted to write a post for each of many of the pregnancy symptoms and afflictions. I decided to start with heartburn because it's currently tormenting me.

I had never experienced heartburn before in my life prior to being pregnant. And I was a huge lover of spicy and fried foods. Which is really a problem now that I'm experiencing this indigestion. If you are like me, then you may not have known much about what heartburn really was (or felt like) prior to you experiencing it yourself! So I will begin with...

What is heartburn?
Heartburn is a burning sensation, usually centered in the middle of the chest near the sternum, caused by the reflux of acidic stomach fluids that enter the lower end of the esophagus. Sometimes the term "heartburn" is used interchangeably with "acid reflux" but heartburn is actually the symptom you feel when you experience acid reflux (which is when stomach acid splashes up from the stomach into the esophagus).

Why do you get heartburn when pregnant?

"Early in pregnancy, your body produces large amounts of the hormones progesterone and relaxin, which tend to relax smooth muscle tissue everywhere in the body, including the gastrointestinal tract. As a result, food sometimes moves more slowly through your system, resulting in indigestion [...] (heartburn is a symptom of indigestion). This may be uncomfortable for you, but it's actually beneficial for your baby. The alimentary slowdown allows better absorption of nutrients into your bloodstream and subsequently through the placenta and into your baby."
~ Heidi Murkoff. What to Expect When You're Expecting.

Also, later in pregnancy (usually the second half for most women), you can experience heartburn because as your uterus expands, it presses on your stomach.
Heartburn is caused when food and digestive juices travel back up from the stomach to the esophagus when the muscle that separates the stomach from the esophagus relaxes. These acids irritate the esophageal lining which causes that burning sensation near where your heart is - hence the term.

You may be more likely to experience heartburn when pregnant if you experienced indigestion before pregnancy, you have been pregnant before, or you are in the later stages of pregnancy.

The frequency of heartburn in pregnancy is reported to be 17-45%. So, know that at least you're not alone!

How do I quench this fire?

There are a few ways you can prevent and alleviate the feelings of heartburn.

1. Avoid foods that you know cause your heartburn. For most people, that includes:
  • rich or spicy foods
  • greasy foods 
  • citrus fruits and juices
  • alcohol (which you shouldn't be drinking much of, if any, at this point anyway...)
  • chocolate
  • caffeine
  • peppermint causes heartburn in some people as well
2. Break your meals into six small meals instead of three large ones. Which, really, is something you should be doing whether pregnant or not. Better for you and helps you not overeat. "Six small meals are the solution to just about whatever pregnancy symptoms are ailing you, from heartburn to bloating to lagging energy level, you name it." (What to Expect)

3. Chew slowly. The more you chew, the less work for your stomach. Also, chewing gum produces saliva, which can help neutralize acid in the esophagus.

4. Sit upright - both while you're eating and after. Eat your last meal at least 2 hours before bedtime and remain upright that whole time (no slouching, leaning, reclining). Also, if you have to bend after eating, bend with the knees, not from the waist. Bending over at the waist will send all that acid up to your esophagus.

5. Wear loose and comfortable clothing, especially around the waist. As cute as you may look in that tight top that shows off your bump, it constricts your stomach and chest which just exacerbates your indigestion symptoms.

6. If it's too late for prevention because you caved and just couldn't help yourself and ordered those fried onions, then you can try some popular folk remedies:
  • papaya: only ripe papaya as unripe papaya apparently can cause uterine contractions. (Must do more research on this as a potential natural labor inducer later...)
  • honey in warm milk: supposedly both yummy and relaxing!
  • almonds
  • ginger (gingerale or ginger candies or ginger added to smoothies, etc): some women say it helps ease an upset stomach, and it combats nausea and vomiting as well. There is not much scientific evidence for ginger as a remedy for heartburn, but it is safe to consume while pregnant.
7. Tums is also safe to consume while pregnant. In fact, the extra calcium is good for you and baby! Just take note, if you are also taking an iron supplement, make sure to take your Tums and iron supplement 2 hours apart, as antacids interfere with your body's ability to absorb the iron properly. 

8. Prop your head up while sleeping. What to Expect says "Sleeping with your head elevated about six inches can keep the burn from waking you up" but that does not work for me. I have to sleep practically sitting up in order for it to not wake me. And even that didn't work last night. *sigh*

So what can I eat?

Since so many pregnancy related books and blogs and sites tell you what you CAN'T eat... here's a list of things you can - that shouldn't cause and even may alleviate heartburn.
  • papaya: ripe papa, not unripe.
  • bananas: with a pH of 5.6, they’re usually great for people with acid reflux, though 1% of the acid reflux afflicted say it worsens their symptoms.
  • melons: cantaloupe, honeydew, watermelon. Like bananas though, 1-2% say it doesn't help.
  • almonds: also a good source of calcium
  • ginger: ginger in a smoothie, gingerale, ginger candies...
  • oatmeal: a fairly bland snack for anytime of day.
  • fennel: a great food for acid reflux with a pH of 6.9. It even seems to improve stomach function. "Sliced thin (the white bottom part), it makes a healthy salad with arugula and baby spinach. It’s also great in chicken dishes, and makes a fine snack if you love the taste." (mild licorice flavor)
  • roots and greens: pretty much all of the greens and root vegetables are recommended for "acid refluxers." Cauliflower, broccoli, asparagus, green beans, celery (which has almost no calories and is also an appetite suppressant), parsley...
  • couscous and rice: "Couscous (semolina wheat), bulgur wheat, and rice (especially brown rice) are all outstanding foods for acid reflux."

What about that old wives' tale?

Many of you may have heard that old folklore that women that experience heartburn when pregnant have babies with more hair on their head. I touted it to just an old wives' tale with not much validity. However... a 2006 study done by Johns Hopkins University found that contrary to expectations, there is a strong association between heartburn and newborn hair. They only surveyed 64 pregnant women, but 78% of them reported some degree of heartburn during their pregnancy. (Side note, there was no relation between their heartburn and the fetal sex, their age, or weight). Most women (23 of 28) "who reported moderate or severe heartburn gave birth to babies with average or above average amounts of hair." The reverse was also true: women who reported no heartburn had babies with less than average or no hair. (US National Library of Medicine)

Well, hopefully this was able to help someone. I know I actually learned some things doing the research for this... going to have to try some of those remedies myself! Good luck with the burn - at least now I know that the slowdown of the digestive process is good for baby... and I will probably have a hairy little boy! :)

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