If mealtime causes discomfort, pain, and a bad case of burning in your throat and chest, you’re not alone. Like so many other pregnancy-related conditions, heartburn is something you might be experiencing for the first time — but it’s totally normal.

Your first thought may be to reach for Tums, a popular (if chalky) remedy for non-pregnancy heartburn. The good news is, it’s fine to do this — but there are a few things to keep in mind.

Pregnancy heartburn is a common condition that close to half of expectant moms can get.

Like many other symptoms in pregnancy, you have hormones to thank for the burning and discomfort you feel after eating. Progesterone and relaxin are both hard at work, slowing down the muscles of the digestive tract.

When this happens, the food you consume tends to move more slowly, and digestion is sluggish, which can trigger post-meal bloat. But it’s the burning sensation caused by foods and acids coming back up from the stomach to the esophagus that causes many women to head for the antacids.

This unpleasant experience happens when pregnancy hormones relax the valve that separates the esophagus from the stomach.

Tums is an over-the-counter (OTC), calcium-carbonate antacid that many people use to manage the symptoms of heartburn.

“Using Tums in pregnancy is something that many OB/GYNs have been prescribing for years,” says G. Thomas Ruiz, MD, OB/GYN lead at MemorialCare Orange Coast Medical Center.

For pregnant women, Ruiz says it does two things:

  • provides supplemental calcium for mom and baby
  • treats pregnancy heartburn

When taken correctly, Tums is safe to use during pregnancy.

Like any other prescription or over-the-counter drug medicine, the dosage and frequency of Tums should ideally come from your doctor. That said, there are some general guidelines to follow when using Tums for heartburn during pregnancy.

Kimberly Langdon, MD, OB/GYN says Tums works best when taken frequently — on the order of every 4 hours — because it neutralizes the acid rather than preventing it from being released.

With that in mind, Langdon says expecting mothers can take a maximum of two tablets every 4–6 hours as needed for heartburn.

“In general, most women will do fine at this dosage — it may only be problematic in women with a history of calcium oxalate kidney stones,” says Langdon.

It’s important to talk to your OB/GYN about any over-the-counter meds you wish to take during pregnancy. When it comes to Tums, this discussion is especially crucial if you have a history of kidney stones.

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Tums comes in a variety of strengths, and most of the recommendations for pregnancy refer to the regular strength, which is the lowest dose at 500 milligrams.

And according to the manufacturer, pregnant women shouldn’t exceed 10 tablets (regular strength) in a 24 hour period, and for no longer than two weeks, except under the supervision of a doctor.

Unless your doctor says otherwise, you should always stick to the recommended dosage, especially since Tums has calcium.

Although calcium is a much-needed mineral during pregnancy, too much of it can lead to side effects such as:

  • constipation
  • increased risk of developing kidney stones
  • irregular heartbeat
  • possible trouble absorbing other minerals, such as iron

For managing heartburn while taking iron supplements, Ruiz says most people take an antacid like Tums after eating. But antacids can decrease iron absorption. If you take an iron supplement, make sure to wait at least 2 hours between taking iron and Tums.

Thyroid medications have a moderate risk of interactions with Tums, so Langdon says to make sure to separate taking those and Tums by at least 4 hours.

As far as side effects, Langdon also says Tums can cause constipation, which is already a problem in pregnancy. It can also cause nausea and stomach upset or pain.

Chewing a few Tums can take the edge off of a bad case of heartburn, but prevention is key if you really want to feel better. That’s why the first line of defense for treating heartburn involves changes to your lifestyle.

Pay attention to what you eat

Avoid spicy, greasy, acidic, and flatulent-producing foods. You may have no problem with these when you’re not pregnant, but they can cause great discomfort when you are.

Some common offenders include:

  • citrus fruits
  • tomatoes
  • mustard
  • processed meats
  • chocolate
  • fatty foods

Stay hydrated with the right fluids at the right time

Drinking water throughout the day is critical during pregnancy. But if you’re experiencing heartburn, minimize the amount of fluids you drink with food, and instead save the water for between meals.

You’ll also want to avoid acidic beverages like citrus juices and soda — especially cola beverages.

Make other meal-time modifications

Smaller, more frequent meals can help prevent heartburn. It also helps to take your time while eating.

Stay upright for a few hours

Because of delayed gastric emptying associated with pregnancy, Ruiz says sitting upright for a couple of hours following meals is ideal. But if you must lie down, he says to lie on your right side to promote gastric emptying. The stomach empties to the right.

Avoid binding clothes

Choose loose-fitting, comfortable clothing rather than tight or binding clothes.

Chew a stick of gum

One simple yet effective tip is to chew a stick of gum after eating. Chewing gum after a meal can help stimulate your salivary glands, which helps neutralize acid.

Some medical alternatives to Tums you may want to discuss with your doctor include:

  • OTC products like magnesium hydroxide (but this should be avoided in the third trimester, according to Langdon)
  • H2 blockers, which can work for heartburn and are safe to take during pregnancy (Ruiz says the most frequently used one is Pepcid AC)
  • Sucralfate (Carafate), a coating agent and prescription drug that can help with heartburn

Although heartburn during pregnancy can be a real pain, minimizing symptoms is possible. By changing your diet, staying upright after eating, and using over-the-counter products like Tums, you can get some relief.

It’s always a good idea to talk to your doctor before taking an antacid. If you experience any adverse side effects, stop taking Tums immediately and call your health care provider.