During pregnancy many OTC medications and natural heartburn remedies are unsafe, though typically fine for those who are not pregnant or breastfeeding. Below are the ones I’ve come across in my research. Over time, I will add others I learn of through the healthcare industry, researchers and from you, my readers. Please consult your physician if you are ingesting or plan to ingest any of these during your pregnancy or while breastfeeding.
The Following Are Considered Unsafe for Heartburn Relief During Pregnancy:
Natural Heartburn Remedies to Avoid During Pregnancy
1) Aloe Vera
Aloe may stimulate uterine contractions and should not be used during pregnancy or breastfeeding. Also, in a study, rats fed dried aloe leaves during pregnancy had offspring with an increased rate of embryonic death and skeletal abnormalities.1
Fresh pineapple in excess can be harmful. Pineapple contains the enzyme bromelain, which can help the digestion process, reducing chances of acid reflux, and settle your stomach but excessive amounts of could cause the cervix to soften and increase the risk of miscarriage. Pineapple juice and canned pineapple are likely to contain little bromelain. The bottling and canning processes kill off the enzyme. Do not take bromelain as a food supplement during pregnancy and watch how much pineapple you ingest.
Papaya contains a digestive enzyme that aids in the breakdown of proteins, but unripened papaya should be avoided then pregnant. Unripened papaya contains a high concentration of latex which can cause uterine contractions and could be unsafe in pregnancy.2
There is very little data on the use of herbs in pregnant women which means the safety of their use in teas is questionable due to the unknown. Many herbs and spices may be toxic when ingested in larger amounts for heartburn treatment, yet fine for culinary use. Herbal teas may contain substances that can cause miscarriage, premature birth, uterine contractions, or harm to the fetus. The FDA encourages caution when consuming herbal teas. If consumed, they should be consumed in moderation because of their unknown effect on mother and baby. Please consult your doctor before using herbal teas. Everyone’s chemistry is different. Your doctor knows your body and condition and is the best source to ask if you are concerned.
Natural licorice is the root of Glycyrrhiza glabra. It contains a component called glycyrrhizic acid or glycyrrhizin. Glycyrrhizin in larger amounts can cause high blood pressure, cause low birth weight and shorter gestation periods, miscarriage, and allows the stress hormone, cortisol, to pass through the placenta to the fetus impairing brain development in the fetus. Significant reduction in verbal and visuospatial abilities, narrative memory, and a significant increase in attention deficit-type behaviors, rule-breaking, and aggression problems were found overexposed to glycyrrhizin during gestation.3,4,5,6,7
Though regular licorice is unsafe during pregnancy, deglycyrrhizinated licorice (DGL) is available to avoid the side effects of the glycyrrhizin in licorice. DGL is considered safer and is available in chewable tablets. Having not found clinical trials on the safety of DGL during pregnancy, I have not listed this as a viable treatment option. Please consult your doctor before taking.
Cinnamon stick, powder, and essential oil can cause the uterus to contract.
Fennel tea can cause contractions and may also cross the placenta and disrupt a developing baby’s endocrine system.
Sage tea has thujone. It has been linked to high blood pressure and miscarriage.
OTC Heartburn Remedies to Avoid During Pregnancy
Those containing aluminum, aspirin, and bismuth subsalicylate Are considered to be unsafe during pregnancy. Aluminum can cause constipation and toxicity in large dosages. Baking soda (sodium bicarbonate) should be avoided due to is high sodium content. And use of bismuth subsalicylate can result in absorption of salicylate which can cause and increase in fetal cardiac malformation.8 Some popular antacids containing aluminum, aspirin, or bismuth subsalicylate:
2) H2 Blockers
The FDA has assigned H2 blockers to the pregnancy category B. Animal testing has shown no evidence of impaired fertility or harm to the fetus, but no know human studies have been done. The benefit of taking these drugs during pregnancy should certainly outweigh the any risk to you or the baby.9,10 H2 Blockers include:
Proton pump inhibitors are used to reduce stomach acid when antacids and H2 blockers aren’t providing the necessary relief. They expose the fetus to some level of risk, though it is considered minimal.11 PPIs include:
- AcipHex (rabeprazole)
- Nexium (esomeprazole)
- Prevacid (lansoprazole)
- Prilosec (omeprazole)
- Protonix (pantoprazole)
- Rapinex (omeprazole)
For related articles, please see:
- Longwood Herbal Task and The Center for Holistic Pediatric Education and Research, Kemper KJ, Chiou V (1999) “Aloe vera”
- National Center for Biotechnology Information, U.S. National Library of Medicine “Papaya (Carica papaya) consumption is unsafe in pregnancy: fact or fable? Scientific evaluation of a common belief in some parts of Asia using a rat model.”
- MedlinePlus: A service of the U.S. National Library of Medicine “Licorice”
- US National Library of Medicine National Institutes of Health “Birth outcome in relation to licorice consumption during pregnancy”
- US National Library of Medicine National Institutes of Health “Preterm birth and licorice consumption during pregnancy“
- US National Library of Medicine National Institutes of Health “Licorice abuse: time to send a warning message”
- US National Library of Medicine National Institutes of Health “Maternal licorice consumption and detrimental cognitive and psychiatric outcomes in children”
- Drugs.com “Bismuth subsalicylate Pregnancy and Breastfeeding Warnings”
- Drugs.com “Nizatidine Pregnancy and Breastfeeding Warnings”
- National Center for Biotechnology Information, U.S. National Library of Medicine “The safety of histamine 2 (H2) blockers in pregnancy: a meta-analysis”
- US National Library of Medicine National Institutes of Health “Are proton pump inhibitors safe during pregnancy and lactation? Evidence to date.”