Dr Bernadette Carr answers your questions on pregnancy, heartburn and spots

I am eight months pregnant and suffering from severe heartburn — at times I find it difficult to sleep because of the pain. I am reluctant to take any medication in case it affects the baby. What can I do?

Heartburn can be a very common occurrence during pregnancy, which may worsen as the baby grows. In most cases it will resolve after pregnancy.

There are a number of things you can do in the meantime to relieve the symptoms without taking medications. It is a good idea to look at your diet and see if there is anything which is triggering your symptoms. Spicy foods such as chillies or curry should be avoided if possible. Onions and peppers may also contribute to heartburn.

Smoking or alcohol will also exacerbate symptoms and these should be avoided in pregnancy. Hot drinks such as tea and coffee may cause heartburn to worsen, as can fizzy soft drinks or colas. Switching these for plain water or herbal teas such as peppermint may improve your symptoms.

Night time can often be particularly bad especially if you are lying flat. It is a good idea to try to avoid large meals before bed, time and try to eat smaller quantities more often to avoid bad heartburn.

Sleeping on your side, propped up on pillows should also help to relieve your symptoms. Some people find that a glass of warm milk before bed will help to ease stomach discomfort as well as aiding restful sleep.

Antacids, which are widely available over the counter, may be helpful and are not harmful in pregnancy if taken in the recommended dose. These can be taken after meals or before bed and will work to neutralise excess acid in the stomach.

If these measures do not work it is a good idea to discuss your symptoms with your GP or obstetrician.

I am a 30-year-old female and have recently started to get spots on my chin. Besides the random spot here and there, I have never suffered from skin problems before. I eat healthily and drink plenty of water and don’t think the basic cleanser and moisturiser can be the cause, but I wonder if they might be a symptom of some other underlying issue.

Inflammation and infection of pores in the skin can lead to spot formation or acne. This is a very common occurrence in young people especially at adolescence, however it may occur later in life and affect women and men in adulthood.

Changes in the body’s hormones (which especially occur at the time of puberty) may trigger changes in the oil production in the skin contributing to the development of blocked pores with comedones (whiteheads) and blackheads.

Bacteria in the skin may cause inflammation with the development of infected pustules which if severe may form larger cysts in the skin, leading to an increased risk of scarring.

Sometimes these changes may be related to stress or certain medications such as contraceptive pills, some women may find they are more likely to experience breakouts at certain times in their menstrual cycle or during pregnancy. Some foods may also trigger breakouts with some suggestion that sugars or dairy products may exacerbate the issue.

Certain other medical conditions such as Polycystic Ovary Syndrome may also lead to breakouts and a family history of adult-onset acne may also make you more likely to experience the problem. It is a good idea to pay attention to any changes in skincare or lifestyle factors that may be contributing to the issue.

Using a non-oil-based moisturiser and making sure to clean the face well after applying makeup or sun lotions can also help to reduce the likelihood of breakouts. Creams containing benzoyl peroxide will reduce the bacteria on the skin.

If these measures are unsuccessful it may be a good idea to visit your GP, who can prescribe antibiotic creams and tablets as well as suggesting other investigations and treatments if these are necessary.