Pregnant caffeine intake

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

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Caffeine Intake During Pregnancy | American Pregnancy Association

Caffeine is one of the most loved stimulants in America. But Because caffeine can raise blood pressure, pregnant women should limit caffeine during pregnancy.

Facts About Caffeine

Caffeine is a stimulant and a diuretic. Because caffeine is a stimulant, it increases your blood pressure and heart rate, both of which are not recommended during pregnancy.
Caffeine also increases the frequency of urination. This causes a reduction in your body fluid levels and can lead to dehydration.

Caffeine crosses the placenta to your baby. Although you may be able to handle the amounts of caffeine you feed your body, your baby doesn’t have the enzymes needed to metabolize caffeine.

Any amount of caffeine can also cause changes in your baby’s sleep pattern or normal movement pattern in the later stages of pregnancy. Remember, caffeine is a stimulant and can keep both you and your baby awake.

Caffeine is found in more than just coffee. Caffeine is not only found in coffee but also in tea, soda, chocolate, and even some over-the-counter medications that relieve headaches. Be aware of what you consume.

Caffeine Facts or Myths?

Statement: Caffeine causes birth defects in humans

Facts: Numerous studies on animals have shown that caffeine can cause birth defects, premature labor, preterm delivery, reduced fertility, and increase the risk of low-birth-weight offspring and other reproductive problems.
There have not been any conclusive studies done on humans; however, it is still better to play it safe when it comes to inconclusive studies.

Statement: Caffeine causes infertility

Facts: Some studies have shown a link between high levels of caffeine consumption and delayed conception.

Statement: Caffeine causes miscarriages

Facts: In 2008, two studies on the effects of caffeine related to miscarriage showed significantly different outcomes. In one study released by the American Journal of Obstetrics and Gynecology, it was found that women who consume 200mg or more of caffeine daily are twice as likely to have a miscarriage as those who do not consume any caffeine.

According to a 2015 meta-analysis, the risk of miscarriage rose by 19% for every increase of 150 mg per day of caffeine and by 8% for every increase of two cups of coffee per day.

In another study released by Epidemiology, there was no increased risk in women who drank a minimal amount of coffee daily ( between 200-350mg per day.)

Due to conflicting conclusions from numerous studies, the American College of Obstetricians and Gynecologists and the March of Dimes recommend that until more conclusive studies are done, pregnant women should limit caffeine intake to less than 200 mg per day. This is equal to about one 12 oz cup of coffee.

How much caffeine is in your favorite drinks & snacks?

Coffee, average (check the specific blend & café that you purchase from for specific levels):
- Brewed, 8 oz. | 95 – 165 mg
- Brewed, decaf, 8 oz. | 2 – 5 mg
- Espresso, 1 oz. | 47 – 64 mg
- Latte, 8 oz. | 63 – 126 mg
Dr. Pepper (12 oz) 37 mg
7 Eleven Big Gulp Diet Coke (32 oz) 124 mg
7 Eleven Big Gulp Coca-Cola (32 oz) 92 mg
Ben & Jerry’s Coffee Buzz Ice Cream (8 oz) 72 mg
Baker’s chocolate (1 oz) 26 mg
Green tea (6 oz) 40 mg
Black tea (6 oz) 45 mg
Excedrin (per capsule) 65mg

Avoiding caffeine as much as possible is your safest course of action. If you must get your fix, it is best to discuss this with your healthcare provider to make the healthiest choice for you and your baby.

Want to Know More?

Herbal Tea and Pregnancy

Compiled using information from the following sources:

1. Organization of Teratology Information Services Mother To Baby

2. Williams Obstetrics Twenty-Second Ed. Cunningham, F. Gary, et al, Ch. 8.

3. https://www.marchofdimes.com

4. Maternal caffeine consumption during pregnancy and the risk of miscarriage: A prospective cohort study. American Journal of Obstetrics and Gynecology, 198, e1-8.. Weng, X., Odouli, R. & Li, D.K. (2008).

5. Caffeine and miscarriage risk. Epidemiology, 19 (1), 55-62. Savitz, D.A., Chan, R.L., Herring, A.H. & Hartmann, K.E. (2008).

6. The Mayo Clinic: Caffeine content in coffee, tea, soda, and more.

Fullscript: Surprising Effects And Sources of Caffeine: Why it Affects People Differently

dose of caffeine | FPA

Author - Natalia Reznik.

In our hectic time, when there is so much to do, many resort to tonics. One of the most famous and affordable is caffeine. However, they must be used with caution. The May issue of Examine.com talks about the benefits and dangers of this stimulant.

Caffeine has been used for a very long time. Its source in India and the countries of the Middle East was coffee; in China, India and Southeast Asia - tea; in America, the yerba mate plant, cocoa beans, guarana leaves, and kola nuts. These days, caffeine is often added to sugary sodas, energy drinks, and weight loss supplements. The vast majority of people use some form of caffeine. In 2016, for example, they drank 7 million tons of coffee. The sale of energy drinks is also on the rise, and Figure 1 shows the caffeine content of some popular products. In drinks poured into cans and bottles, it is standard, but in a cup of coffee it can vary markedly.

Fig. 1 Where and how much do we get caffeine.

What is the overdose?

There is no exact answer to this question - the safe dose of caffeine depends on the state of health. Some people drink strong coffee all day without any harmful effects, while others have a pressure jump from a single cup, sleep is disturbed, their head hurts and their nerves are naughty. However, caffeine-induced nervousness can be alleviated by the amino acid L-theanine, which is found in green tea leaves. Interestingly, similar symptoms are observed in people with caffeine withdrawal. They also yawn, complain of fatigue, runny nose, muscle stiffness, it is difficult for them to concentrate. Alas, caffeine cannot be considered a completely safe product.

Healthy adults - allowed within reasonable limits

Authoritative organizations such as the European Food Safety Authority (EFSA), the US National Academies of Sciences (NAS) and Health Canada have concluded that healthy adults can safely consume up to 400 mg of caffeine per day. More than 400 mg can be taken on special occasions (for example, during emergency preparation for an exam). Such a dose will not cause side effects if such force majeure occurs rarely.

The effects of caffeination depend on the time of intake. Most people can drink 200 mg of caffeine at a time less than 2 hours before intense exercise. However, even 100 mg can disturb sleep if you drink coffee or an energy drink at night. Caffeine leaves the body rather slowly, the half-life is about five hours, so people who drank strong coffee less than 10 hours ago still have some amount of alkaloid wandering in the blood.

So, healthy adults can consume up to 400 mg of caffeine per day, but not at bedtime.

Pregnant and lactating women - handle with care

The European Food Safety Authority recommends that lactating and pregnant women, as well as those who are just planning a pregnancy, limit their daily intake of caffeine to 200 mg. Some experts allow up to 300 mg / day, however, according to some reports, caffeine causes nausea in pregnant women and, much worse, the risk of miscarriage.

There are very few clinical studies on the effects of caffeine on pregnant and lactating women, and in such a situation it is wiser to limit the intake of alkaloid. In pregnant women, the time required to remove caffeine from the body increases by more than three times, so caffeine can accumulate: drunk in the evening is added to what has been preserved in the morning, and the total dose of the substance circulating in the blood is higher than the calculated one.

So, pregnant and lactating women should not exceed the daily dose of 200 mg, although they are allowed 300 mg.

Children and adolescents - better to refrain

Data on safe doses of caffeine for children and adolescents is clearly insufficient. According to European experts, young consumers will not be harmed by 3 mg / kg of body weight per day. In Canada, no more than 2.5 mg/kg/day is considered safe. In accordance with these standards, children, depending on age, are allowed to:

4-6 years - 45 mg/day
7-9 years - 62.5 mg/day
10-12 years 85 mg/day.

Not everyone agrees with this opinion. So, in 2013, a group of honored American doctors sent a letter to the US Food and Drug Administration calling for a ban on the sale of caffeinated drinks in schools. Scientists point out that caffeine concentrations in energy drinks are strongly correlated with adverse health outcomes in children, adolescents, and young adults.

So the safe level of caffeine for children and adolescents has been determined, but some medical organizations are calling for more thorough research on this issue, and until the data is collected, the less caffeine the child consumes, the better.

Suffering from cardiovascular diseases - consult a doctor

Caffeine increases blood pressure for 3-4 hours, this is a proven fact. However, with regular consumption, this effect is not so noticeable. In healthy people who do not exceed the allowed 400 mg, the risk of developing cardiovascular disease does not increase. But for people with high blood pressure or those who have already suffered cardiovascular disease, in other words, for patients who are contraindicated in stimulants, the consequences of caffeine intake are not so obvious. Moderate amounts will not hurt them, but it is best to consult a doctor about specific doses.

So, for people with high blood pressure or who have had cardiovascular diseases, regular consumption of caffeine-containing drinks is not indicated. There should be no harm from small portions, but it is better to consult.

How much do you have to drink to hit your caffeine limit?

To answer this question, you need to know how much caffeine is in each cup/can/bottle you drink. This information is contained in Figure 1, but for those who find it difficult to concentrate without caffeine, as well as for adherents of a mono-diet (as they started the day with coffee from McDonald's, they won't take anything else caffeinated in their mouths) there is also Figure 2.

Fig. 2 How many and what drinks can you drink so as not to exceed the daily caffeine limit of 400 mg.

And what happens if you sort it out?

When taken orally, 15 mg of caffeine per kilogram of body weight is toxic, and 150 mg is lethal. That is, a person who weighs 68 kg will be poisoned by one gram of caffeine, and will die from 10 g. Think about it before drinking 10 cans of energy drinks on a bet.

Powdered caffeine is a special song. It is used as a nerve stimulant and advertised as a fitness and muscle builder, and some people take it arbitrarily for that purpose. The US Food and Drug Administration warns that one teaspoon of pure caffeine powder is equivalent to 28 cups of coffee. To allow an overdose of powder is much easier than to overdrink energy drinks. A large amount of caffeine increases the activity of the sympathetic nervous system, causes a strong heartbeat and convulsions.

While caffeine powder poisoning is rare, it does happen, and sometimes fatally. Both athletes who independently take this substance and specialists are mistaken. So at the University of Northumbria, scientists, conducting an experiment, accidentally gave two students 30 grams of caffeine instead of 300 mg. The students, fortunately, survived, but they had to spend some time in the hospital.

If you are healthy, you can safely drink drinks containing caffeine, guided, of course, by figures 1 and 2, but it is better not to deal with the powder.

The best thing to do

All of the above recommendations are based on the long-term effects of regular caffeine intake. Higher doses, up to 800 mg, may be taken on special occasions if health permits. So, in one study rugby players took different doses of caffeine before training. The alkaloid increased the content of testosterone in the blood, that is, it showed itself as an anabolic. However, the 800 mg dose also increases the concentration of cortisol, which has a catabolic effect.

The more often you swallow large portions of caffeine, the more likely you are to feel its negative effects. In addition, with frequent use, some of the caffeine benefits are lost, a kind of tolerance is developed. To avoid this, caffeine is taken periodically. This makes sense if caffeine is drunk for the release of adrenaline, and regular breaks in drinking coffee, tea and energy drinks are necessary for the synthesis of dopamine. But if caffeine is hoped to reduce the risk of developing Parkinson's disease or type 2 diabetes, it must be consumed regularly, and it is better not to swallow powders, but to drink tea and coffee. Caffeine lowers blood glucose levels, but if you take the powder, this effect weakens.

High doses of caffeine increase physical performance, but regularly exceeding the upper limit of consumption is detrimental to health. What's more, both regular and infrequent use of caffeine have their own benefits. It all depends on the effect you want to achieve.

Source: https://examine.com/

Effect 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].