RECOMMENDATION, SIDE EFFECTS, AND PREGNANCY CONCERNS

When you are pregnant, you tend to be more conscious of your health and diet. You give up things like alcohol, sushi made with raw fish, and unpasteurized soft cheese. But, what about caffeine? Do you have to give up your morning coffee or other products that contain caffeine, too? Here’s what you need to know about caffeine during pregnancy.

The Recommendation for Caffeine Safety During Pregnancy

Caffeine is an ingredient in many beverages, foods, and snacks.

Even if you wanted to, it could be hard to avoid caffeine altogether. Thankfully, you don’t have to worry too much about taking in a small to moderate amount of caffeine each day. Experts such as the March of Dimes and the American Congress of Obstetricians and Gynecologists (ACOG) say it’s safe to have up to 200 mg a day. That is equal to approximately one or two 8 ounce cups of coffee. Now, we are talking 8-ounce cups here, not two Dunkin’ Donuts Large or Starbuck’s Venti-size cups!

How It Affects a Pregnant Mother

Even though it takes longer to clear caffeine from the body during pregnancy, pregnant mothers can usually tolerate a small to moderate amount of caffeine well. However, some women who had no issue with caffeine before pregnancy may discover it affects them differently once they’re expecting. Women who once loved that first cup of coffee in the morning may not be able to stomach the smell or taste of it anymore.

If you find you can still tolerate caffeine, it’s OK to have a cup of coffee. Just keep in mind that caffeine is a drug and it can have side effects: It’s a stimulant. A stimulant increases the heart rate and blood pressure. It may keep you awake and give you energy, but too much caffeine can make you feel anxious and shaky. It can also cause sleep difficulties and insomnia.

• It’s a diuretic. A diuretic removes water from the body. It can give you the urge to urinate more. However, In moderate amounts, it is not likely to cause dehydration.
• It’s addictive. With regular use, your body gets accustomed to caffeine. If you stop it suddenly, you can experience symptoms of withdrawal that include a headache, irritability, and fatigue.

How It Affects an Unborn Baby

Caffeine does cross the placenta and makes its way to the baby. During pregnancy, a baby’s body is still developing. The liver, brain, and nervous system are immature and cannot handle caffeine the same way a full-grown adult can. While experts aren’t exactly sure how too much caffeine affects the baby, there are a few things they do know:

• Caffeine stimulates the baby, so you may feel the baby is more active not long after you have a cup of coffee or soda.
• It may increase the baby’s heart rate, and cause an irregular heartbeat or sleep disturbances.
• It is also difficult for the developing baby to clear too much caffeine from his body. With continued consumption of high amounts of caffeine, the drug can build up in the baby’s body. After birth, a newborn may show symptoms of withdrawal including irritability, tremors , and disrupted sleep patterns. It is safer for the baby if you can limit your caffeine intake below 200 mg a day.

Pregnancy Concerns

Women often wonder if caffeine can cause birth defects, pregnancy loss, preterm labor, or other birth-related problems. Research is still ongoing, but small amounts of caffeine do not appear to cause any problems for pregnant women or their babies. It’s only in very high doses that caffeine is believed to be an issue:

• Birth defects:While exposure to large amounts of caffeine can cause an irregular heart rate, there is no concrete evidence to suggest that caffeine causes any deformity or disability in the baby.
• Miscarriage:There is conflicting information when it comes to caffeine and pregnancy loss. One analysis of 26 studies concludes that caffeine could increase the chances of pregnancy loss. The authors state that the risk of miscarriage goes up by 19 percent for each increase in caffeine intake of 150 mg per day. Other research shows that the risk of miscarriage is higher when women take in more than 200 mg of caffeine each day. But, not all studies agree. A different study reports that any amount of caffeine on its own does not increase the risk of miscarriage. It’s only when caffeine is combined with other factors such as smoking, drinking alcohol, or using drugs that the incidence of pregnancy loss is higher.
• Premature Labor:Research indicates that small to moderate amounts of caffeine do not cause preterm labor.
• Low Birth Weight:Studies show that there is an association between caffeine and low birth weight. Caffeine may also increase the chance of having a baby who is small for gestational age (SGA) even when it is limited to the recommended amount. The risk appears to be lower for those who take in less than 100 mg a day.

The Amount of Caffeine in Popular Foods and Drinks

There are some products such as regular coffee that you know have caffeine. But, caffeine is a common ingredient in many other foods and beverages. Foods that don’t list caffeine as an ingredient aren’t necessarily caffeine-free. Even decaffeinated items can still have a small amount.

Here are some of the drinks and snacks that you may enjoy and how much caffeine they contain. The amount of caffeine in each item listed below is a general average. There may be a little more or little less because the actual amount of caffeine in each product depends on the brand and the way it’s made:

Over-the-Counter Medications

Before taking any medications including over-the-counter (OTC) products, talk to your doctor to be sure that they are safe. The two most used OTC medications that have caffeine as an active ingredient are Excedrin and Midol.

• Excedrin contains 65mg of caffeine per caplet or geltab. The products Excedrin Extra Strength, Excedrin Migraine, and Excedrin Tension Headache have the same dose of caffeine. There is no caffeine in Excedrin PM Headache.
• Midol Complete has 60mg of caffeine in each caplet. Midol and Midol Long Lasting Relief are caffeine-free.

When you’re pregnant, you want to make the best choices for you and your baby. It can be confusing and more difficult to make an informed decision when there’s conflicting information. The best thing you can do is talk to your doctor at your Prenatal appointments. Your doctor will monitor you and your baby and keep you updated on the most recent recommendations.

If you aren’t a coffee or soda drinker, you’re already ahead of the game. If you like your coffee or tea, you may want to cut back a little. But, as long as you aren’t experiencing any side effects, you can still enjoy it in moderation. Just don’t overdo it. Until there is more conclusive research available about caffeine and miscarriage, it’s better to be on the safe side and stay within the recommended amount of up to 200 mg a day.

<Sources>:

American College of Obstetricians and Gynecologists. Moderate caffeine consumption during pregnancy. ACOG Committee Opinion No. 462. Obstetrics and Gynecology. 2010;116(2):467-8.

Briggs, Gerald G., Roger K. Freeman, and Sumner J. Yaffe. Drugs in Pregnancy and Lactation: A Reference Guide to Fetal and Neonatal Risk. Lippincott Williams & Wilkins. 2012.

Chen LW, Wu Y, Neelakantan N, Chong MF, Pan A, van Dam RM. Maternal caffeine intake during pregnancy and risk of pregnancy loss: a categorical and dose-response meta-analysis of prospective studies. Public health nutrition. 2016 May;19(7):1233-44.

Sengpiel, V., Elind, E., Bacelis, J., Nilsson, S., Grove, J., Myhre, R., Haugen, M., Meltzer, H.M., Alexander, J., Jacobsson, B. and Brantsæter, A.L., 2013. Maternal caffeine intake during pregnancy is associated with birth weight but not with gestational length: results from a large prospective observational cohort study. BMC Medicine, 11(1), p.42.

Somogyi LP. Caffeine intake by the US population. Prepared for The Food and Drug Administration and Oakridge National Laboratory. 2010 Nov.