Pregnancy is a time of constant change for both you and your growing baby.

Along with all the kicks and jabs, you may notice that your baby hiccups inside the womb. Is this normal?

Here’s what you need to know about baby hiccupping in the womb, and when to contact your doctor.

Your baby meets many different milestones before they’re born. Each stepping-stone gets them closer to being able to survive in the real world. You’ll probably become aware of your little one’s movements by weeks 18 to 20. This is when fetal movement, also known as quickening, is often experienced for the first time.

Seasoned moms may feel quickening sooner in subsequent pregnancies. For others, it may take a bit longer depending on factors like weight and placenta position.

On average, fetal movement can first be felt between weeks 13 and 25. It often starts as little butterfly kicks, or it might feel like popcorn popping in your belly. After a while, you’ll feel kicks, rolls, and nudges throughout the day.

Do you ever notice other movements like rhythmic twitching? These motions may feel more like muscle spasms or other pulsing. But they might be fetal hiccups.

You may start to notice fetal hiccups in your second or third trimester. Many moms start to feel these “jerky motions” in their sixth month of pregnancy. But like fetal movement, everyone starts to feel them at a different time.

Some babies get the hiccups several times a day. Others may not get them at all. The cause of hiccups isn’t well-understood. This goes for why they happen in kids and adults, too. One theory is that fetal hiccups play a role in lung maturation. The good news is, in most cases, this reflex is normal and just another part of pregnancy.

It’s important to note that fetal hiccups are, in general, considered a good sign. After week 32, though, it’s less common to experience fetal hiccups every day. You may want to contact your doctor if your baby continues to hiccup daily after this point, with the episodes lasting over 15 minutes, or if your baby has three or more series of hiccups in a day.

Moving around is the best way to determine if your baby has hiccups or is kicking. Sometimes, your baby might move if they’re uncomfortable in a certain position, or if you eat something hot, cold, or sweet that stimulates their senses.

You may feel these movements in different parts of your belly (top and bottom, side to side) or they may stop if you reposition yourself. These are likely just kicks.

If you’re sitting completely still and feel a pulsing or rhythmic twitching coming from one area of your belly, these might be baby’s hiccups. After a while, you’ll grow to know that familiar twitch.

Hiccups are typically a normal reflex. It’s been suggested, though, that if they’re frequent and persistent in later pregnancy, they could signal a cord problem.

Umbilical cord compression or prolapse, when the blood and oxygen supply slows or is cut off from the fetus, typically happens in the last weeks of pregnancy or during childbirth.

Complications of cord issues may include:

In a review about umbilical cord problems as a cause of stillbirths published in BMC Pregnancy & Childbirth, the authors noted that a study of sheep showed that fetal hiccups could be caused by umbilical cord compression.

The authors suggested that increased hiccups occurring daily after week 28 and happening more than 4 times each day might warrant more evaluation from your doctor. However, since the study was done on animals, it’s unclear if this is true in humans.

If you experience a sudden change in your baby’s hiccups after 28 weeks, for example, if they’re stronger, or last longer than usual, you may want to contact your doctor for peace of mind. They can examine you and find out if there’s an issue. They can also help ease your worries if everything’s fine.

Your baby will move a lot as the weeks roll on. You might worry about these movements or even feel uncomfortable. For this reason, it’s a good idea to count kicks in late pregnancy. Paying attention to fetal movements can help you determine if your little one’s doing OK.

Here’s how to count kicks:

  • Starting in your third trimester (or earlier, if you’re high-risk), take time to count how long it takes for your baby to make 10 movements including kicks, jabs, or pokes.
  • A healthy baby usually moves many times in a two-hour period.
  • Repeat this process each day, preferably at the same time of day.
  • Baby not moving very much? Try drinking a glass of cold water or eating a small snack. You may also try pushing gently on your stomach to wake them.

Most women can feel 10 movements within just 30 minutes. Give yourself up to two hours. Call your doctor whenever you have concerns, or if you notice a large shift in movements from day to day.

Overall, it’s a good idea to pay attention to your baby’s movements. If you notice changes, talk to your doctor.

As far as feeling comfortable, you might try a few things to ease the aches, pains, and stress of frequent fetal movements. Try lying on your left side propped with pillows, especially if you want a good night’s sleep. Eat healthy foods, and drink plenty of water and other fluids.

Regular physical activity can also give you extra energy and even help with stress relief. Heading to bed at the same time each night and taking naps can also help you feel better during the day.

In most, if not all, cases, fetal hiccups are a normal reflex. They’re a normal part of pregnancy. Your baby has a lot to do to practice for their debut on delivery day.

If your baby’s hiccups ever give you reason for concern, contact your doctor. Soon enough, you’ll get to see your little one hiccupping outside of your tummy. Just hang in there!