Caffeine is our stimulant of choice in America and millions of us rely on a jolt of java or the gentle kick of a cup of tea to get us through the day (or the first few hours of the morning). Now that you're pregnant do you have to give up your caffeine habit for the full nine months? Does caffeine harm you or your unborn baby during pregnancy? Is there any difference between drinking coffee and tea when pregnant? If you were used to drinking caffeinated beverages - or eating a lot of chocolate - before pregnancy you need to know the facts about caffeine now that you're drinking for two.
How Does Caffeine Affect Your Pregnancy?
Caffeine is a stimulant. Caffeine in coffee, tea, soft drinks, chocolate, over-the-counter painkillers and many other preparations increases both your blood pressure and your heart rate. Both of these raises are not recommended in pregnancy. Caffeine is also a diuretic. This means it makes you pee more, which can result in a reduction of your bodily fluids and possible dehydration. Again, this is not ideal in pregnancy. (Read more about the connection between coffee and high blood pressure.)
As for your baby, caffeine crosses the placenta and your baby ingests it. While you may be fine with three double-espressos on the hop, your baby's metabolism hasn't matured like yours and he cannot properly metabolize what you can. Caffeine may disrupt your baby's sleep patterns and movements.
So does this mean that caffeine is completely out-of-bounds when you are pregnant?
Can Pregnant Women Have Caffeine?
While there is still debate as to how much effect caffeine has on a baby's development, experts don't tell pregnant women to give up caffeine completely. A moderate intake of caffeine has not been shown to produce negative effects on pregnancy or the baby's health.
What's moderate? If you were on three Grande Starbucks a day you may need to cut down - the experts' view on moderate is between 150mg to 300mg of caffeine a day, according to the American Pregnancy Association. The March of Dimes non-profit organization states that, until we have concrete evidence, women should stick to 200mg of caffeine a day and no more.
How Many Cups of Coffee Are Too Many?
The amount of caffeine in a 12oz cup of coffee is about 200mg, according to the American Pregnancy Association. But be careful because every coffee, caffeinated drink or snack contains a different amount of the stimulant - one Venti coffee from Starbucks (20oz, 415mg of caffeine) would push you over the recommended limits, for example.
Brewed coffee has around 95-200 mg while instant coffee has 27-173mg per 8oz. Black tea, brewed (8oz) has between 30-80 mg of caffeine, a can of Diet Coke has around 47mg, a Hershey's 1.6oz milk chocolate bar has 9mg and a Starbucks hot chocolate (16oz) 25mg. Two Midol Complete caplets contain 120mg of caffeine (Data from Center for Science in the Public Interest.)
Why is it necessary to monitor your caffeine levels in pregnancy? Is there any evidence that caffeine harms your baby or negatively affects your pregnancy outcome?
Can Caffeine Cause Birth Defects?
There are no conclusive studies completed on humans but experts say that caffeine can cause preterm delivery, birth defects and low birth weight. A 2010 study from Erasmus Medical Center, Rotterdam, Netherlands demonstrated that daily caffeine intake of six or more units throughout pregnancy is associated with impaired fetal length growth and it could also affect fetal skeletal growth.
The study looked at 7,346 pregnant women and asked for their caffeine habits by questionnaire, but there is no reference to exactly what one unit of caffeine comprised. However, a 2012 study from the National Food and Nutrition Institute, Warsaw, Poland says a caffeine intake of no more than 300 mg per day during pregnancy does not affect the duration of the pregnancy or the condition of the newborn.
Does Caffeine Cause Miscarriage?
The facts on caffeine and miscarriage are contradictory. One 2008 study from Division of Research, Kaiser Permanente, Oakland, CA reported an increased dose of daily caffeine during pregnancy was linked with an increased risk of miscarriage and that women who consumed 200mg or more of caffeine a day were twice as likely to have a miscarriage as those who did not consume any. But a 2008 study from Mount Sinai School of Medicine, New York showed little indication of miscarriage risk in women who drank a small amount of coffee each day (between 200-350mg per day.)
A 2003 study by the Regional Agency for Public Health, Tuscany, Florence, Italy suggested that caffeine consumption above 300mg a day resulted in an increased risk of miscarriage, although nausea was a protective factor against this risk.
According to a 2000 study from the Department of Medical Epidemiology, Karolinska Institute, Stockholm, Sweden more miscarriages occurred in women who consumed at least 100mg of caffeine a day than women who consumed less.
With a limited number of studies on this subject it is hard to get any concrete evidence as to caffeine's effect on child development. A 2012 study from Tilburg University, Netherlands looked at maternal caffeine consumption and future child problem behavior and found no association between caffeine intake and a higher risk of behavioral problems or anti-social behavior.
The Caffeine and Pregnancy Mix
While some women will want to avoid caffeine altogether while there is still uncertainty over possible risk - and the extent of the risk - this is a personal decision and pregnant women are not currently advised to give up coffee, tea and caffeinated soft drinks altogether.
Limiting your intake while you're pregnant -- especially if you were a caffeine-addict before --- is a good idea, however. The less you consume the better but you can still enjoy a small cup of morning cup of joe without guilt.