Drinking too much caffeine while pregnant

Caffeine in pregnancy | March of Dimes

We don’t know a lot about the effects of caffeine during pregnancy on you and your baby. So it’s best to limit the amount you get each day.

If you’re pregnant, limit caffeine to 200 milligrams each day. This is about the amount in 1½ 8-ounce cups of coffee or one 12-ounce cup of coffee.

If you’re breastfeeding, limit caffeine to no more than two cups of coffee a day.

Caffeine is a drug found in things like coffee, tea, soda, chocolate and some energy drinks and medicines. It’s a stimulant, which means it can keep you awake.

How does caffeine affect you and your baby during pregnancy?

Caffeine slightly increases your blood pressure and heart rate and the amount of urine your body makes. Caffeine may cause you to feel jittery, have indigestion or have trouble sleeping. During pregnancy, you may be especially sensitive to caffeine because it may take you longer to clear it from your body than if you weren’t pregnant. It may also make you feel nauseous or lightheaded.

When you have caffeine during pregnancy, it passes through the placenta to your baby. The placenta grows in your uterus (womb) and supplies the baby with food and oxygen through the umbilical cord.

You may have heard that too much caffeine can cause miscarriage (when a baby dies in the womb before 20 weeks of pregnancy), preterm birth (birth that happens before 37 weeks of pregnancy is completed) or low birth weight (when your baby is born weighing less than 5 pounds, 8 ounces). Some studies say this is true, and others don’t.

Until we know more about how caffeine can affect pregnancy, it’s best to limit the amount you get to 200 milligrams each day. This is about the amount in 1½ 8-ounce cups of coffee or one 12-ounce cup of coffee. Be sure to check the size of your cup to know how much caffeine you’re getting.

What foods and drinks contain caffeine?

Caffeine is found in:

Coffee and coffee-flavored products, like yogurt and ice cream
Tea
Some soft drinks
Energy drinks
Chocolate and chocolate products, like chocolate syrup and hot cocoa
Some medicines

The amount of caffeine in foods and drinks varies a lot. For coffee and tea, the amount of caffeine depends on:

The brand
How it’s prepared
The type of beans or leaves used
The way it’s served (for example, as espresso or latte)
The size of the cup. Not all coffee cups are the same size, even though you think of them as a cup. Check to see how many ounces your cup has, especially if you’re buying a cup of coffee or tea. If you’re making coffee or tea at home, measure to check the size of the cup.

Some energy drinks contain large amounts of caffeine. For example, a 24-ounce energy drink may have up to 500 milligrams of caffeine. Energy drinks may have a lot of sugar, too, and they may contain ingredients that may be harmful to your baby during pregnancy. Because we don’t know a lot about all the ingredients in energy drinks, it’s best not to have them when you’re pregnant.

The amount of caffeine you get from food and drinks throughout the day adds up. So if you have a cup of coffee in the morning, you may want to limit or give up having other food and drinks during the day that have caffeine.

The list below shows the amount of caffeine in common food and drinks. The caffeine amounts are averages, so they may change depending on the brand or how the food or drink is made. Check the package label on food and drinks to know how much caffeine they contain.

What medicines contain caffeine?

Some medicines used for pain relief, migraine headaches, colds and to help keep you awake contain caffeine. The Food and Drug Administration (also called FDA) requires that labels on medicine list the amount of caffeine in the medicine.

If you’re pregnant, talk to your health care provider before taking any medicine that contains caffeine. This includes prescription and over-the-counter medicine. A prescription is an order for medicine given by a health care provider. You can buy over-the-counter medicine, like pain relievers and cold medicine, without a prescription.

Some herbal products contain caffeine. These include guarana, yerba mate, kola nut and green tea extract. Herbal products are made from herbs, which are plants that are used in cooking and for medicine. The FDA does not require that herbal products have a label saying how much caffeine they contain. If you’re pregnant, don’t use herbal products because we don’t know how much caffeine they contain.

Is caffeine safe during breastfeeding?

The American Academy of Pediatrics (AAP) says it’s safe for breastfeeding moms to have caffeine. A small amount of caffeine does get into breast milk, so limit caffeine if you’re breastfeeding. Breastfed babies of women who drink more than 2 to 3 cups of coffee a day may become fussy or have trouble sleeping. You may want to drink less caffeine if your baby was born preterm or newborn because she may digest caffeine more slowly.

Last reviewed: April 2020

Many pregnant women are over-consuming caffeine

Tommy's PregnancyHub

A poll by Tommy’s has found that 61% of women would reduce the amount of caffeine they consume after being made aware of how much caffeine there is in daily items.

Over-consumption of caffeine (more than 200mg daily) is linked to miscarriage, low birth-weight and fetal growth restriction, but many women are unaware what 200mg represents in real life.

Caffeine is ‘hidden’ in many products including chocolate and energy drinks
Tommy’s caffeine calculator helps women track their consumption

Since 2008 the Food Safety Authority (FSA) has recommended that pregnant women keep their caffeine intake to under 200mg a day, but evidence from Tommy’s, the pregnancy and baby charity, shows that women do not know what 200mg caffeine represents and are over-consuming.

A poll of 4,100 pregnant women conducted by Tommy’s showed that 61% would reduce their caffeine consumption habits after being made aware of how much caffeine there is in daily items.

Babies of pregnant women who consume over 200 mg of caffeine per day are at an increased risk of fetal growth restriction which could result in low birth weight and/or miscarriage.

“There is evidence that excessive caffeine intake is associated with an increased risk of miscarriage. Interestingly, this evidence seems to apply to not just women during pregnancy, but also to men, pre-conception. Although more research is required, most clinicians would recommend couples to restrict their caffeine intake.”
Professor Arri Coomarasamy, Clinical Director of Tommy’s National Miscarriage Research Centre

Caffeine is found in tea and coffee, cola, other soft beverages such as energy drinks and chocolate. A mug of tea has around 75mg and a bar of plain chocolate has around 25mg.

“Caffeine consumption can add up so quickly! Two cups of coffee and a bar of chocolate would have enough caffeine to be over the recommended limit while pregnant. Try switching to decaffeinated coffee, herbal teas, fruit juice and water. Don’t worry if you have in the past gone over the 200mg limit but using a caffeine calculator now can help you be more aware of your consumption and to cut down if you need to. ”
Sophie King, Tommy’s midwife

"I've never been a big caffeine drinker and I assumed that a couple of mugs of tea or coffee each day wouldn't take me over the caffeine limit in pregnancy. I decided to check on Tommy's caffeine calculator and I was surprised to see I am going over the recommended limit of 200mg. A mug of tea and a filter coffee takes me just over to 215mg - and a chocolate bar (my current craving) pushes it up even more to 240mg. I had no idea! I'm going to make an effort to stick to one tea or coffee now."
Clio, a mum expecting her third baby

NOTES TO EDITORS:

4,100 pregnant women responded to the poll conducted between April-December 2017
Tommy’s caffeine calculator is free to use here
The campaign hashtag is #caffeinewise
Further information for risk assessments on caffeine consumption from the European Food Safety Authority https://www.efsa.europa.eu/en/efsajournal/pub/4102

For more information or to request an interview with Professor Arri Coomarasamy or Sophie King please contact the Tommy's press office on 0207 398 3436 or email [email protected]

Tommy’s is the largest pregnancy and baby charity in the UK. We fund research into pregnancy problems and provide pregnancy health information to parents-to-be. We believe it is unacceptable that one in four women lose a baby during pregnancy and birth. With four research centres across the UK investigating the causes of miscarriage, stillbirth and premature birth, we lead the way in maternal and fetal research in the UK.

Our pregnancy health information is provided through the midwife-led Tommy’s Pregnancy Health Service, which includes our comprehensive pregnancy information website, our Tommy’s Midwives facebook page and our free Midwives helpline, the PregnancyLine. We believe every pregnancy should have a happy ending and that every baby should have the best chance of being born healthy.

www.tommys.org

Charity reg. nos 1060508 and SC039280

Effects of restricted maternal caffeine intake on pregnancy, fetal and newborn outcomes

Caffeine is a stimulant found in tea, coffee, cola, chocolate and some over-the-counter drugs. Conflicting literature has made it difficult for health professionals to advise pregnant women on whether caffeine intake should be avoided during pregnancy. The clearance of caffeine from the mother's blood (clearance of caffeine from the blood) is slowed down during pregnancy. Some authors of observational studies have concluded that caffeine intake is harmful to the fetus, causing growth restriction, low birth weight, preterm labor, or stillbirth. The newborn may also experience withdrawal symptoms if the mother consumes large amounts of caffeine during pregnancy (more than eight cups of coffee per day). nine0003

Two studies met the inclusion criteria, but only one contributed data to the outcomes of interest for the review. The study was conducted in Denmark. Women less than 20 weeks pregnant were randomized to either caffeinated instant coffee (568 women after elimination) or decaffeinated instant coffee (629 women). Three cups of coffee per day in early pregnancy had no effect on birth weight, preterm birth, or growth restriction. nine0003

Both included studies were randomized controlled trials. In one study, pregnant women were randomly assigned to caffeinated or non-caffeinated groups. In another clinical trial, it was not clear if the allocation to study groups was blinded [hidden]. The blinding of study staff and participants was satisfactory in both studies, while blinding of investigators evaluating outcomes was not clearly stated. One study also unclearly explained the presence of attrition bias (dropouts, loss of patients from follow-up). Results from one trial that provided data for analysis showed no evidence of an effect of caffeine withdrawal on outcomes such as birth weight, preterm birth, and small-for-gestational age [gestational age]. nine0003

Two outcomes were assessed and assigned a quality rating using the GRADE methodology. The quality of the evidence for these two outcomes, namely birth weight and preterm birth rate, was rated as low, with downward decisions due in part to the relatively small sample sizes and wide confidence intervals of the single included trial that contributed data to this review.

There is insufficient evidence to confirm or refute the effectiveness of avoiding caffeine intake on birth weight and other pregnancy outcomes. nine0003

Translation notes:

Translation: Yudina Ekaterina Viktorovna. Editing: Ziganshina Lilia Evgenievna. Russian translation project coordination: Kazan Federal University - an affiliated center in Tatarstan of the Northern Cochrane Center. For questions related to this translation, please contact us at: [email protected]

How much coffee can pregnant women and how caffeine affects the expectant mother and child

And not only coffee: can pregnant women drink drinks and products that contain caffeine? How does this natural stimulant affect a mother with a baby in her stomach and how to please and cheer yourself up instead of coffee? nine0003

Irina Obraztsova

Legion-Media

It seems that a cup a day is still allowed. But it is not exactly. Find out what experts advise and what percentage of caffeine is found in different coffees, teas and foods.

Contents of the article

Conditional allowable dose of caffeine for pregnant women

The effects of caffeine, it would seem, have been studied up and down, but in relation to pregnancy, scientists can say that caffeine affects mother and baby, but how exactly - it is still difficult to answer . Not all mechanisms are fully understood, studies contradict each other, so concessions are allowed: coffee, unlike alcohol, is allowed for pregnant women, albeit in very small doses. For example, the American College of Obstetricians and Gynecologists (ACOG) advises pregnant women to limit their caffeine intake to less than 200 milligrams per day, which is about one cup. nine0003

Conflicting data on safe doses of caffeine for pregnant women

Although there is a conditional allowance of 200 ml of coffee per day, some experts believe that caffeine in any amount during pregnancy may pose a risk.

Previously, scientists have found an association between high doses of caffeine during pregnancy with low fetal weight for gestational age and the risk of intrauterine growth retardation (IUGR). Recently, researchers from the National Institutes of Health found that women who drank just half a cup of coffee a day, or less than 200 mg of caffeine during pregnancy, had fewer children than women who did not drink caffeinated beverages. nine0003

According to these studies, caffeine causes constriction of blood vessels in the uterus and placenta, which can reduce the blood supply to the fetus and slow down its growth. In addition, caffeine has the potential to interfere with fetal stress hormones, putting infants at risk for rapid weight gain after birth, obesity, heart disease and diabetes later in life.

However, other studies have shown different results and found no association between moderate caffeine intake during pregnancy (less than 200 mg per day) and problems such as low birth weight, IUGR, miscarriage or preterm birth. That's why OB/GYNs around the world do not prohibit pregnant women from consuming caffeine in moderation. nine0003

Since research is still ongoing, and scientists have not come to a consensus, you should not experiment on yourself and your baby and drink more than one invigorating "cup of coffee" per day.

How caffeine affects pregnancy

When you drink a cup of coffee, caffeine passes through the placenta into the amniotic fluid and your baby's bloodstream. Your adult body knows how to get rid of unwanted substances with the help of metabolism, in the womb these processes are not yet established, and it takes him much longer to process caffeine, which means that the baby is exposed to a natural stimulant much longer than an adult. nine0003

If in everyday life you have no noticeable reactions to coffee (except for enjoyment), then during pregnancy caffeine can obviously harm your health. Since it is a stimulant, it raises your heart rate and blood pressure, which can make you nervous and sleepless. Caffeine can exacerbate other pregnancy problems as well, such as more frequent heartburn and less frequent trips to the bathroom.

As pregnancy progresses, the effect of caffeine may increase: the body breaks it down more slowly, and after drinking coffee, a higher level of caffeine remains in the blood. In the second trimester, it takes almost twice as long for caffeine to clear out of your body than when you're not pregnant. In the third trimester, the process takes almost three times as long. Quite a lot of caffeine remains in the body of a woman for a long time, crosses the placenta and gets to the child, who cannot process it effectively. nine0003

Another good reason not to overdo tea and coffee (even without caffeine) is the compounds they contain, which make it difficult to absorb iron. It is already in short supply in many pregnant women. Drink tea and coffee between meals, so they will less affect the absorption of iron.

When can I drink pre-pregnancy coffee again?

It depends. If you are breastfeeding, it is advisable to limit the amount of caffeine in the first months after childbirth, because part of the stimulant substance enters the baby with breast milk. nine0003

What foods and drinks contain caffeine?

Caffeine is not only found in coffee. It is also found in various types of tea, in addition, well-known food brands add caffeine to their soft drinks and desserts. Caffeine is also found in herbal products and over-the-counter medications, including some headache, cold, and allergy medications. Read labels carefully!

If you add up everything you eat and drink in a day, you'd be surprised how much of a stimulant you actually consume. nine0003

One serving of coffee may contain different amounts of caffeine. It depends on the type of beans, how they are roasted, how they are brewed, and the size of the cup. And although espresso has a higher caffeine level per gram of drink, it is served in a tiny cup. So a large glass of Americano still has more caffeine.

Approximate amounts of caffeine in drinks from different manufacturers

For example, a large cup of coffee (about 400 ml) of one famous fast food chain contains from 145 mg of caffeine, and in Americano of its competitor - 260-360 mg. One capsule for a coffee machine contains about 60 mg of a stimulant. Decaf coffee is also not harmless - it can contain up to 25 mg of caffeine. In tea in the same cafes, it is slightly less than in coffee, but more than in decaf: 30-95 mg. The Iced Tea drink has only 21 mg per large cup. In soda, a variety of colas (0.33l bottle) - 20-70 mg of caffeine, energy drinks - more, on average 150 mg. In one small piece of dark chocolate, on average, 20 mg of caffeine, in an incomplete glass of coffee ice cream - can reach up to 65 mg, in chocolate milk - up to 8 mg per cup.

How can I help myself stop drinking coffee during pregnancy or cut it down to one cup?

It's easy. But not just for coffee lovers. If yesterday you drank 3-4 cups of an invigorating drink a day, then it will not be easy to “get off” it. However, the desire to drink coffee in the morning can evaporate with the onset of toxicosis. Your body will not crave coffee in the morning. And not only coffee, but about everything will try to return back. After the end of toxicosis, you will not even remember the stimulant. If nothing can dampen your cravings for an invigorating drink, here are some tips on how you can help yourself to give up coffee:

Do not give up your usual coffee volumes overnight. In order not to experience the "withdrawal syndrome" - headaches, irritability, lethargy - reduce the dose gradually. However, set yourself a foreseeable time frame in which you will come to the permitted cherished 200 mg per day.
Try mixing drinks to lower your caffeine levels. For example, decaffeinated coffee with regular coffee, gradually increasing the content of the first one. Or mix some coffee and lots of milk. At home, put fewer spoons of coffee in the cezve (and leaves or tea bags in the kettle) for the same volume of water as before, or brew drinks for a shorter time. Letting a tea bag steep for just one minute instead of five will cut the amount of caffeine in half. nine0090
Switch to decaffeinated drinks. Or at least drink a second cup without it (more precisely, they still have caffeine, but 5-10 times less).
Look for other sources of energy. Try to get enough sleep at night, go to bed early and rest during the day whenever possible. Eat well and be sure to exercise (for pregnant women!) - even light exercise will give you a boost of energy.
You can also gradually switch to herbal teas. But it is important to remember that herbs are the same “chemistry” as pills (that is, they have some kind of active substance in their composition that can somehow affect the body).
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