Effects of too much caffeine during pregnancy

Moderate daily caffeine intake during pregnancy may lead to smaller birth size

Pregnant women who consumed the caffeine equivalent of as little as half a cup of coffee a day on average had slightly smaller babies than pregnant women who did not consume caffeinated beverages, according to a study by researchers at the National Institutes of Health. The researchers found corresponding reductions in size and lean body mass for infants whose mothers consumed below the 200 milligrams of caffeine per day — about two cups of coffee — believed to increase risks to the fetus. Smaller birth size can place infants at higher risk of obesity, heart disease and diabetes later in life.

The researchers were led by Katherine L. Grantz, M.D., M.S., of the Division of Intramural Population Health Research at NIH’s Eunice Kennedy Shriver National Institute of Child Health and Human Development. The study appears in JAMA Network Open.

“Until we learn more, our results suggest it might be prudent to limit or forego caffeine-containing beverages during pregnancy,” Dr. Grantz said. “It’s also a good idea for women to consult their physicians about caffeine consumption during pregnancy.”

Previous studies have linked high caffeine consumption (more than 200 milligrams of caffeine per day) during pregnancy to infants being small for their gestational age (stage of pregnancy) or at risk for intrauterine growth restriction—being in the lowest 10th percentile for infants of the same gestational age. However, studies on moderate daily caffeine consumption (200 milligrams or less) during pregnancy have produced mixed results. Some have found similar elevated risks for low birth weight and other poor birth outcomes, while others have found no such links. The current study authors noted that many of the earlier studies did not account for other factors that could influence infant birth size, such as variation in caffeine content of different beverages and maternal smoking during pregnancy.

For their study, the authors analyzed data on more than 2,000 racially and ethnically diverse women at 12 clinical sites who were enrolled from 8 to 13 weeks of pregnancy. The women were non-smokers and did not have any health problems before pregnancy. From weeks 10 to 13 of pregnancy, the women provided a blood sample that was later analyzed for caffeine and paraxanthine, a compound produced when caffeine is broken down in the body. The women also reported their daily consumption of caffeinated beverages (coffee, tea, soda and energy drinks) for the past week—once when they enrolled and periodically throughout their pregnancies.

Compared to infants born to women with no or minimal blood levels of caffeine, infants born to women who had the highest blood levels of caffeine at enrollment were an average of 84 grams lighter at birth (about 3 ounces), were .44 centimeters shorter (about .17 inches), and had head circumferences .28 centimeters smaller (about .11 inches).

Based on the women’s own estimates of the beverages they drank, women who consumed about 50 milligrams of caffeine a day (equivalent to a half cup of coffee) had infants 66 grams (about 2. 3 ounces) lighter than infants born to non-caffeine consumers. Similarly, infants born to the caffeine consumers also had thigh circumferences .32 centimeters smaller (about .13 inches).

The researchers noted that caffeine is believed to cause blood vessels in the uterus and placenta to constrict, which could reduce the blood supply to the fetus and inhibit growth. Similarly, researchers believe caffeine could potentially disrupt fetal stress hormones, putting infants at risk for rapid weight gain after birth and for later life obesity, heart disease and diabetes.

The authors concluded that their findings suggest that even moderate caffeine consumption may be associated with decreased growth of the fetus.

About the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD): NICHD leads research and training to understand human development, improve reproductive health, enhance the lives of children and adolescents, and optimize abilities for all. For more information, visit https://www.nichd.nih.gov.

About the National Institutes of Health (NIH): NIH, the nation's medical research agency, includes 27 Institutes and Centers and is a component of the U.S. Department of Health and Human Services. NIH is the primary federal agency conducting and supporting basic, clinical, and translational medical research, and is investigating the causes, treatments, and cures for both common and rare diseases. For more information about NIH and its programs, visit www.nih.gov.

NIH…Turning Discovery Into Health^®

References

Gleason, JL et al. Maternal caffeine consumption and metabolism and neonatal anthropometry in the NICHD Fetal Growth Studies. JAMA Network Open. 2021. doi:10.1001/jamanetworkopen.2021.3238

###

Connect with Us

Contact Us
Twitter
Facebook
Instagram
YouTube
Flickr

Caffeine During Pregnancy: How Much Is Safe?

Caffeine is a stimulant that provides a boost of energy and makes you feel more alert.

It’s consumed worldwide, with coffee and tea being two of the most popular sources (1).

While caffeine is considered safe for the general population, health authorities advise limiting your intake when expecting (2).

This article discusses how much caffeine you can safely consume during pregnancy.

For many people, caffeine has favorable effects on energy levels, focus and even migraines. Additionally, some caffeinated beverages offer health benefits.

However, caffeine can cause negative side effects in some and may pose risks during pregnancy.

Potential benefits

Caffeine is proven to improve energy levels and focus.

Research shows that caffeine stimulates your brain and central nervous system, which may help you stay awake and sharpen mental alertness (2, 3).

It may also be effective at treating headaches when combined with pain relievers, such as acetaminophen (4).

Additionally, some caffeinated beverages contain antioxidants, beneficial compounds that can protect your cells from damage, reduce inflammation and ward off chronic disease (5, 6).

Green tea is especially high in antioxidants, but other teas and coffee contain substantial amounts as well (7, 8).

Potential risks

Caffeine has many potential benefits, but there’s concern that it may be harmful when consumed during pregnancy.

Pregnant women metabolize caffeine much more slowly. In fact, it can take 1.5–3.5 times longer to eliminate caffeine from your body. Caffeine also crosses the placenta and enters the baby’s bloodstream, raising concerns that it can affect the baby’s health (9).

The American College of Obstetricians Gynecologists (ACOG) states that moderate amounts of caffeine — less than 200 mg per day — are not linked to an increased risk of miscarriage or preterm birth (10).

However, research suggests that intakes greater than 200 mg per day may raise the risk of miscarriage (11).

Additionally, some evidence suggests that even low intakes of caffeine may result in low birth weight. For example, one study found that low intakes of 50– 149 mg per day during pregnancy were associated with a 13% higher risk of low birth weight (9, 12).

However, more research is needed. The risk of miscarriage, low birth weight and other adverse effects due to higher intakes of caffeine during pregnancy remains largely unclear.

Other negative side effects of caffeine include high blood pressure, rapid heartbeat, increased anxiety, dizziness, restlessness, abdominal pain and diarrhea (2, 13).

summary
Caffeine may boost energy levels, improve focus and help relieve headaches. However, it may pose risks when consumed in high amounts during pregnancy, such as an increased risk of miscarriage and low birth weight.

The ACOG recommends limiting your caffeine intake to 200 mg or less if you are pregnant or trying to become pregnant (14).

Depending on the type and preparation method, this is equivalent to about 1–2 cups (240–580 ml) of coffee or about 2–4 cups (240–960 ml) of brewed tea per day (1).

Along with limiting your intake, you should also consider the source.

For instance, the Academy of Nutrition and Dietetics recommends avoiding energy drinks entirely during pregnancy.

In addition to caffeine, energy drinks usually contain high amounts of added sugars or artificial sweeteners, which lack nutritional value.

They also contain various herbs, such as ginseng, that have been deemed unsafe for pregnant women. Other herbs used in energy drinks have not been adequately studied for their safety during pregnancy (15).

Moreover, you should avoid certain herbal teas during pregnancy, including those made with chicory root, licorice root or fenugreek (16, 17).

The following herbal teas have been reported as safe during pregnancy (17):

ginger root
peppermint leaf
red raspberry leaf — limit your intake to 1 cup (240 mL) per day during the first trimester
lemon balm

As with any herbal remedy, it’s a good idea to consult with your doctor before drinking herbal teas during pregnancy.

Instead, consider caffeine-free beverages, such as water, decaf coffee and safe caffeine-free teas.

summary
During pregnancy, limit caffeine to less than 200 mg per day and avoid energy drinks entirely. Some herbal teas may be safe to drink, but it’s always best to check with your doctor first.

Coffee, teas, soft drinks, energy drinks and other beverages contain varying amounts of caffeine.

Here’s a list of the caffeine content in some common drinks (1, 18):

Coffee: 60–200 mg per 8-oz (240-ml) serving
Espresso: 30–50 mg per 1-oz (30-ml) serving
Yerba mate: 65–130 mg per 8-oz (240-ml) serving
Energy drinks: 50–160 mg per 8-oz (240-ml) serving
Brewed tea: 20–120 mg per 8-oz (240-ml) serving
Soft drinks: 30–60 mg per 12-oz (355-ml) serving
Cocoa beverage: 3–32 mg per 8-oz (240-ml) serving
Chocolate milk: 2–7 mg per 8-oz (240-ml) serving
Decaffeinated coffee: 2–4 mg per 8-oz (240-ml) serving

Note that caffeine is also found in some foods. For example, chocolate can contain 1–35 mg of caffeine per ounce (28 grams). Typically, dark chocolate has higher concentrations (18).

Additionally, certain medications like pain relievers may contain caffeine, and it’s frequently added to supplements, such as weight loss pills and pre-workout mixes.

Be sure to check with your doctor if you’re concerned about the caffeine content of your diet.

summary
The amount of caffeine in coffee, teas, soft drinks, energy drinks and other beverages varies. Foods like chocolate, certain medications and various supplements often contain caffeine as well.

Caffeine is popularly consumed worldwide. It’s been shown to boost energy levels, improve focus and even relieve headaches.

Though caffeine has benefits, health authorities recommend watching your intake during pregnancy.

Most experts agree that caffeine is safe during pregnancy if limited to 200 mg or less per day. This equals about 1–2 cups (240–580 mL) of coffee or 2–4 cups (540–960 mL) of caffeinated tea.

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).

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.

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].

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.

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]

Working with coffee during pregnancy, how to combine them?

Contents show

Working in the coffee industry is not easy, especially for women. You need to be in good physical shape, as you have to work on your feet for 8-10 hours and at the same time be very friendly with the guests of the coffee shop. We thought about it ... and decided to translate an article about women who faced these problems during pregnancy.

Pregnancy and Coffee: A Little Bundle Of Challenges by Amanda Skriver (@amascriver), a Toronto freelance journalist.

Pregnancy and coffee: a small set of problems

Pregnancy is considered by many to be a time of joy and celebration. But for women working in the coffee industry, who prepare and taste coffee every day, the happiness of future motherhood can bring some challenges, from a slight change in taste habits to increased susceptibility to smells. The job of brewing a great drink can be not only difficult, but also risky for pregnant coffee professionals.

Pregnancy and coffee: a small set of problems
Smell and taste begin to fail
Coffee consumption should be limited
Fatigue and physical changes
Maternity leave. Not everywhere
Return to work
Video: Women in the coffee industry: from farmer to barista

In 2014, the Center for Science in the Public Interest published an article citing metastudy of the European Journal of Epidemiology. It suggests that women who consume even 100 milligrams of caffeine per day have a 14 percent increased risk of stillbirth and 19percent are more at risk of miscarriage. The World Health Organization recommends that pregnant women limit their caffeine intake to 300 mg per day. The implications are clear, but the many coffee professionals who help produce and brew coffee across North America are coping with the potential risks by finding ways to make great, delicious coffee.

Smell and taste begin to fail

During pregnancy, the senses are overloaded, hormones affect how a particular product smells and tastes. Changes can occur almost overnight, making certain drinks and foods more palatable or flavorful. “Changes in hormones, particularly estrogen, during the first trimester can contribute to unexpected changes in taste and smell sensitivity. This may also be the reason for the increase in blood volume during pregnancy, so all impulses transmitted from the blood to the brain and olfactory center reach their destination faster and with a vengeance,” explains Abby Sharp, nutritionist writing for Abbey’s Kitchen. When smell is half of what helps us taste, it's no surprise that baristas, trainers and roasters can face specific challenges day in and day out.

In addition to women drinking coffee at home, professional tasks such as cupping, tasting and setting up coffee equipment for different types of coffee create additional challenges during pregnancy. “My sense of smell became stronger, so I could more easily recognize the right notes while tasting,” says Brian Curzey, who runs Intelligentsia Coffee in New York. But sometimes the heightened sensory perception can be a little stronger than it should be. “I couldn’t stand the taste of espresso during my pregnancy, which used to be the most desired drink,” says Kerzi. “It became very difficult to be 100 percent sure of my espresso settings and I had to ask another barista to check them.”

“The smell of coffee made me sick, which made things a little more difficult,” says Andrea Allen, co-owner of the Onyx Coffee Lab in Arkansas. During her pregnancy, Allen had to call for help, from tweaking equipment settings to double-checking the quality control of her shots.

I smell menthol in every cup.

Jen Apodaka, director of roasting at Royal Coffee in Auckland, says that during her second pregnancy, she began to smell menthol in every cupping (tasting) of coffee, which she had to ignore. “During my second trimester, I was getting certified as a Q-grader, which proved to be very difficult,” says Apodaka. – It was difficult to recognize a certain cup of three, and each coffee intake caused heartburn. I also had heightened taste sensitivity and had to constantly concentrate to find reliable sensory memory cues. I felt Professor X in Cerebro »

For many pregnant coffee girls, it becomes vital to find alternative ways to get on with your job. The myriad of physiological and physical changes a woman's body experiences during pregnancy can affect everything from coffee sensitivity in cupping, tasting, and equipment settings to practical occupational issues such as longer toilet breaks, more frequent meals and water, and also the need to limit the time spent on the legs.

Coffee consumption should be limited

Learn more about limiting coffee consumption during pregnancy.

Layla Gambari, former director of Cherry Street Coffee House and current director of education and training for Stumptown Coffee, trained herself and taught others in preparation for the barista championship while pregnant. While she says she hasn't been very strict about the various dietary restrictions that pregnant women face, she has agreed that it has affected her work. “My main concern was the amount of caffeine consumed during pregnancy,” says Gambari. “It's very easy to overdose on caffeine during competition, so I had to take care of myself. I noticed that from a lot of caffeine and dehydration I started to feel dizzy. ”

Fatigue and physical changes

Ultimately, the biggest concern for those in the industry are the physical changes that can occur to the body during pregnancy. Changes in blood chemistry can cause fluids to shift, which can cause swelling throughout pregnancy. For many baristas, the working day is eight to ten hours. But studies have shown that standing for long periods of time can reduce a baby's growth rate and cause preterm labor.

“Before getting pregnant, I worked until everything was done, but during pregnancy I had to stop doing that, I quickly got tired,” says Allen. “In truth, I did my best and rested when needed.” Allen thanks her employees (and her husband) for their support, providing more comfortable working conditions and help with those ordinary things that she easily coped with in ordinary life, but during the period of bearing a child she could no longer do.

Apodaka experienced many physical changes that affected her daily work. “In addition to feeling terrible in the morning with morning sickness and heartburn, my legs were swollen and I easily knocked everything around with my stomach,” she says. “It was also terrible that I couldn’t lift anything. I had to sit and rest more between work tasks.”

Maternity leave.

It is not available everywhere

Working with coffee during pregnancy is difficult, but it is possible, and in the postpartum period it does not become much easier. for which maternity leave is not paid.

In the United States, the Family and Medical Leave Act (FMLA) requires most companies to give their employees up to 12 weeks of unpaid maternity leave to care for a child after a child is born. However, this is not guaranteed, as the FMLA also includes certain exceptions that exempt employers from the obligation to provide unpaid leave, depending on the size of the company, the length of employment, or wages. For a small coffee shop that provides such extended vacations while maintaining a job, logistical and financial difficulties can arise that cause the company to refuse to help employees.

The United States of America is one of only two countries in the world - the other Papua New Guinea - that does not provide paid maternity leave.

“Before, we did not practice maternity leave, so we needed to resolve this issue,” Gambari explains while on maternity leave. During their employment at the Cherry Street coffee shop, the company committed itself to providing two months of maternity leave, but Gambari was also able to earn extra money, as this is their family business, for example, as in the case of Allen and her Onyx coffee shop. (Ali Gambari, Laila's father, opened the first Cherry Street coffee shop at 90s). Although, it also happens that the woman herself wants to go to work immediately after the birth of the child.

Return to work

“After one day at home, I returned to work with my daughter River in a sling. I did it because I was bored and didn't really do anything,” says Allen. “I had a light workload at work and didn’t work at full capacity until she was four months old.”

Apodaka describes: “With Borden, my first child, I was on vacation for six weeks and could no longer be out of work. My return to work was a holiday for me, if I could, I would work six days a week. I remember roasting coffee on Sundays to get ready for the new work week. I have wonderful memories of roasting coffee in the snow with a baby on my chest.”

But for others, returning to work may not be such a pleasant and welcome moment. In addition, most women leave the hospitality industry in order to find a job with a more suitable work schedule and more comfortable working conditions, both before and after the birth of a child. So what can be changed? This is a difficult question for coffee business owners: how to find an opportunity to help their employees who want to have a baby. From support during pregnancy to paid maternity leave and childcare benefits, it's all the help women need at this time.

“A newborn baby at home is even more difficult than the pregnancy itself, at least in my case,” says Allen. Finding time to sleep, feed, then take the child to the nursery and straight to work, while doing it well, is very exhausting. More coffee shops need to think about these issues with their baristas, trainers and roasters in order to find solutions for the future.