Caffeine & Pregnancy: How Much Can Baby Take?

 Ok, you know the big no-no’s in pregnancy: alcohol, tobacco, recreational drugs – even some prescription medications – raw fish, soft cheeses, and so on . . . but caffeine?!  America’s favorite stimulant is so much a part of so many women’s lifestyles that it’s often overlooked when it comes to pregnancy.  But since 1980, the medical community has been issuing warnings against excessive caffeine during gestation.  

Caffeine: Its Effects on Mom and Baby

Caffeine is a stimulant found in a wide variety of foods, drinks, and even certain medications.  It’s valued as a pick-me-up, particularly in a society where sleep deprivation is common.  However, it does have a marked effect on the mother and – because it can cross the blood-placenta barrier – on the baby as well.

In mothers-to-be, caffeine has a number of physical effects.  It raises the heart rate and the blood pressure and can cause indigestion and insomnia – none of which are exactly beneficial when you are pregnant. Also, caffeine can increase urination and make it easier to become dehydrated – which, again, you don’t want for you or your baby.

In babies, there are physical effects as well.  It can increase the fetal heart rate and put undue stress on the heart.  It also increases fetal respirations and activity level in the uterus, and some doctors worry that the baby’s developing body cannot metabolize and excrete caffeine as efficiently as its mother. This means the effects on the baby may be longer-lasting.

What Else Does it Do?

The physical effects on mother and baby mentioned above aren’t controversial: they have been documented in many different studies.  But what about the connection between caffeine and miscarriage or stillbirth?  The connection with low birth weight or premature birth?  The results on these questions have been more conflicted.

Caffeine and miscarriage.  One disturbing study, published in 2008 in the American Journal of Obstetrics and Gynecology, looked at the relationship between women’s caffeine consumption and rates of miscarriage.  It found that women who consumed more than 200 mg of caffeine daily nearly doubled the risk of miscarriage.

Caffeine and stillbirths.  A study out of Denmark found that in women who drink eight cups of coffee or more a day (or the equivalent) double their risk of stillbirth (death of the baby in the uterus after 20 weeks of pregnancy).

Caffeine and low birth weight.  Although some have wondered if there is a connection between caffeine consumption and low birth weight, the American College of Obstetricians and Gynecologists report that there is, to date, insufficient evidence. 

But the Good News Is . . .

For women who are horrified at the thought of giving up their cup of java in the morning, there is good news. The American College of Obstetricians and Gynecologists have issued their Committee Opinion that moderate caffeine consumption at the rate of 200 mg or less does not appear to have any effect on the risk of miscarriage or premature birth.

The March of Dimes – an advocacy organization for pregnancy health and the prevention of birth defects – has weighed in on the issue, too. Since the safe level of caffeine appears to be somewhere between 150 and 300 mg a day, it too has agreed with the ACOG and recommends that women limit caffeine use to 200 mg – just to be on the safe side.

How Much Will 200 mg Get You?

If you are trying to keep your caffeine intake below the recommended 200 mg, here’s an idea of just how much caffeine may be lurking in some of your favorite beverages and foods:

• 1 8-ounce cup of coffee: 137 mg
• 1 8-ounce cup of tea: 48 mg
• 1 12-ounce can of soda averages 37 mg (this can vary widely!)
• 1 8-ounce glass chocolate milk: 5 mg
• 1 ½-ounce square of dark chocolate: 30 mg

If You Are Trying to Quit or Cut Down

Does 200 mg sound like a drop in the bucket compared to what you normally drink? Here are some tips if you are trying to quit or cut down on caffeine:

• Make the change gradually. Going “cold turkey” can be tough on your body and cause headaches, irritability, and fatigue.
• To gradually reduce caffeine intake, begin mixing decaf coffee into your morning java and slowly increase the proportion so that your body has time to adjust.
• Substitute regular coffee with decaf coffee, tea, juice, or water to prevent dehydration.

Other Considerations

Here are some other things to keep in mind when it comes to caffeine and pregnancy:

• As you advance in your pregnancy, your body will become less able to metabolize and eliminate the caffeine: by your third trimester, your ability to metabolize it will be three times less than it was when you got pregnant.
• If you intend to breastfeed, be aware that caffeine can be passed to your baby through the breastmilk and lead to sleep disturbances or upset stomachs. You will have to restrict your caffeine intake after birth as well.
• Read labels on everything you eat and drink if you are not sure of its caffeine content.  Some products that contain caffeine will surprise you.
• Be careful of herbal preparations: some herbs such as guarana, yerba mate, and kola nut naturally contain caffeine. And always talk to your doctor before using any kind of herb while pregnant. 

Do you drink caffeine while you’re pregnant?  Why or why not?