When most of us experience heartburn, we reach for a medication like TUMS, one of the most popular and accessible over-the-counter antacids out there. But if you’re pregnant and getting hit with heartburn, you might be wondering if TUMS, or other calcium carbonate antacids, are safe to take.
As it turns out, the answer is yes, TUMS are generally approved for managing heartburn in pregnancy, says Angela Walker, M.D., an OB-GYN and co-author of The Game Plan: A Woman’s Guide to Becoming a Doctor and Living a Life in Medicine.
We spoke with OB-GYNs and midwives to learn the low-down on taking TUMS during pregnancy, including side effects, dosage, and other options for heartburn relief.
What Is TUMS?
TUMS is a type of antacid used to treat heartburn, indigestion, and other mild digestive upsets. Its main ingredient is calcium carbonate. TUMS is over-the-counter, which means that you don’t need a prescription from a doctor to obtain it. Besides TUMS, other examples of over-the-counter antacids include Rolaids, Mylanta, and Maalox.1
TUMS and other calcium carbonate antacids can treat a variety of common conditions, such as the following:2
- Gastroesophageal reflux disease (GERD) or heartburn
- Damage to the upper gastrointestinal tracts caused by NSAIDs
- Sour stomach
- Biliary reflux
Usually, TUMS come in the form of a chewable, chalky tablet. Other antacid brands can also be taken in capsule or liquid form.
Most often, TUMS are taken three or four times a day, as directed by a health care provider.3 They are a form of calcium, so caution should be taken if you have elevated calcium levels or an underlying condition that could be affected by excess calcium.2
How Do TUMS Work?
When you have heartburn, you’re experiencing an increase in stomach acid. Antacids like TUMS neutralize your stomach acid and increase your stomach’s pH. TUMS also inhibits the production of pepsin,4 an enzyme that generates stomach acid as it breaks down your food. Finally, calcium carbonate boosts gastrointestinal motility, so that your stomach acid gets moved into your stomach, where it belongs.
Why Might Pregnant People Take TUMS?
If you’ve ever been pregnant, you know the havoc that heartburn can wreak on your life. It’s one of the most prevalent and uncomfortable conditions in pregnancy, with 17% to 45% of pregnant individuals experiencing it. Heartburn increases in frequency as you move deeper into your pregnancy; 22% of people feel it in the first trimester, 39% are plagued by it in the second trimester, and 60-72% experience its misery in the third trimester.5
Why exactly is heartburn so common in pregnancy? You can mostly blame hormones, such as increased levels of progesterone, which relaxes the smooth muscles6 and slows down gastric motility. Additionally, the pressure of the growing baby and uterus on the stomach can cause the esophageal sphincter to weaken or become displaced, allowing food and gastric acid to pass from the stomach into the esophagus.
When pregnant folks have heartburn, TUMS is usually one of the first medications they reach for, says Susan M. Stone, CNM, a certified nurse midwife with UTHealth Houston and UT Physicians. “Pregnant people seem to enjoy the easy availability and low cost of antacids containing calcium carbonate that are over-the-counter without a prescription,” she says. Not only that, but antacids containing calcium carbonate such as TUMS are quite effective in managing mild, occasional heartburn, says Stone.
Is TUMS During Pregnancy Safe?
TUMS are often recommended for pregnant people who experience upset stomach, acid reflux, and gas, explains Dr. Walker. Calcium carbonate-based antacids are generally considered safe while expecting.7
What’s more, research shows that calcium carbonate supplements don’t increase the risk of miscarriage, and they aren’t expected to increase the risk of birth defects. Other complications, such as preterm delivery and low birth weight, also haven’t been associated with calcium carbonate.8
How to Take TUMS While Pregnant
Our experts answered parents’ most common questions about the best ways to take TUMS during pregnancy, as well as any necessary safety precautions.
How much TUMS can pregnant people take?
Pregnant people should aim for around 1,000 mg of calcium per day, according to the National Institutes of Health. Those under 18 years old need about 1,300 mg daily. That said, pregnant people should be careful not to exceed the maximum recommended daily limit of 2,500 mg (or 3,000 mg for teens). Side effects of excess calcium may include poor kidney function, constipation, nausea, abnormal heart rhythms, and more.9
Kristin Mallon, CNM, RN, certified nurse-midwife and co-founder and CEO at FemGevity, recommends starting with a lower dose of TUMS. “I usually recommend the lowest dose of TUMS, so that you can take more TUMS more often,” she says. This means taking normal-strength TUMS and avoiding extra-strength varieties. Usually one TUMS, or even half of a TUMS, will work to alleviate symptoms, says Mallon.
How often can you take TUMS?
Although taking TUMS is fine during pregnancy, you don’t want to go overboard. “A good rule of thumb with TUMS is two in the morning and two in the evening, or no more than five in one day unless advised otherwise by your doctor,” says Dr. Walker.
What type of TUMS are best?
Dr. Walker recommends choosing a regular-strength TUMS, with no added ingredients. Each variety of TUMS has a different calcium level, so make sure to check the product bottle.
Who should avoid TUMS while pregnant?
Always consult with a health care provider before taking any medication in pregnancy, reminds Dr. Walker. She says that if you’re taking iron supplements, you should avoid using TUMS within two hours, as this can decrease the amount of iron your body absorbs.10
Additionally, if you have a history of kidney stones or another medical condition that requires you to avoid excess calcium, you may want to stay away from TUMS. Consult your health care provider for guidance.
Other Ways to Treat Pregnancy Heartburn
TUMS are a quick and easy way to relieve heartburn, but as the experts warn, you want to take TUMS in moderation. Moreover, treating heartburn in pregnancy usually requires a multi-faceted approach—making certain lifestyle tweaks and trying other potential remedies.
One of Mallon’s top tips for relieving heartburn in pregnancy is to change your eating habits. “Eating small, frequent meals allows for gastric acid to catch up with the delayed gastric emptying that comes with progesterone increases in pregnancy,” she shares.
Tips from the American College of Obstetricians and Gynecologists (ACOG) for managing heartburn include:
- Elevate your head while sleeping
- Avoid foods (e.g., spicy, acidic) that seem to make your heartburn worse
- Sit upright after eating; avoid lying down
- Avoid smoking
- Talk to a health care provider about medication options (antacids or otherwise) that may work best for you11
Heartburn during pregnancy is common, but it can be disruptive and uncomfortable. You shouldn’t have to just “grin and bear it.” If taking TUMS or other methods for managing heartburn aren’t working well enough for you, make sure to contact a health care provider for further assistance.