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Can You Drink Coffee When Pregnant?

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Your days of tequila shots and tuna sashimi are over — at least for the next nine months or so. But will that venti extra-caf do something bad to your baby? The short answer: No one is completely sure.

“It’s difficult to get good and accurate studies on pregnant women,” says David Elmer, M.D., an ob-gyn at Nantucket Cottage Hospital in Nantucket, Massachusetts. “It isn’t ethical to give 1,000 pregnant women an unknown drug and see how many have complications — so most of the evidence comes from retrospective studies, where we look at people who happen to encounter a particular drug or substance to see if they’re having more problems than those who don’t.” In most retrospective studies, the evidence suggests that caffeine isn’t a big issue. “The overwhelming evidence is that it really isn’t as bad as we think,” he says.

  • How Much Caffeine Is Safe to Consume?
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In fact, Dr. Elmer describes one highly caffeinated mom-to-be who drank no fewer than six cups of coffee per day, sometimes up to 24 in a single day. “She carried the pregnancy uneventfully, with no birth defects or changes in growth, but she did end up going into premature labor,” Dr. Elmer says. “It’s hard to know for sure if caffeine caused it. You have to look at the entire lifestyle of someone who would drink 24 cups of coffee in a day — perhaps she was smoking, she was working in a high-stress environment, or she used other products excessively.” Still, some concerns still remain because animal studies say otherwise. Although “there are no conclusive studies in humans, studies in animals do show decreased fertility, increases in birth defects and miscarriage rates, and low-birthweight babies,” says Michele Hakakha, M.D., a board-certified ob-gyn in Beverly Hills, California and author of Expecting 411.

But what about decaffeinated coffee? Decaf may seem like a great alternative, but it contains trace amounts of caffeine. According to the Mayo Clinic, a single cup of decaf has between 2 and 12 milligrams of caffeine. So if you like the taste and can do without that caffeine buzz, you can have (lots) more decaf coffee before you hit the 200-milligram limit. “It’s ok to drink decaf coffee and tea during pregnancy, but to not overdo it,” says Elisa Zied, M.S., R.D., C.D.N., a dietitian in New York City and author of Feed Your Family Right. Even small amounts of caffeine in so-called decaf products can add up if you’re having multiple servings.

  • Is Tea Better for You During Pregnancy?
  • Read Elisa Zied’s Blog: The Scoop on Food

So should you try to stop your Starbucks habit cold turkey the second that pregnancy test turns blue? “People get rebound headaches when they cut back on caffeine, so cutting back slowly is better than going cold turkey, especially when there’s no good evidence of it being a big problem. Somebody who’s a six- or eight-cup of coffee person could cut down to five or fewer, and aim for just two to three cups a day,” Dr. Elmer says. Just take it slow and gradually reduce your coffee intake. Try “having a smaller cup, switching to decaf, diluting your coffee with milk or cream, or start drinking tea, which has some caffeine but much less than coffee,” Dr. Hakakha suggests. Although the most conservative ob-gyn probably wouldn’t deny you that daily cup of joe, the American College of Obstetricians and Gynecologists does recommend calling it quits at 200 milligrams per day — which is about the amount in one eight-ounce cup of regular coffee. (Keep in mind, though, that the super-caffeinated coffee at Starbucks is over the 200-milligram limit, even at the smallest “tall” size.) “My advice to patients is: no more than one, and on occasion, two caffeinated drinks a day,” Dr. Hakahka says. “Always avoid something that might be potentially dangerous to your developing fetus.” But even if you do have to cut back on the coffee now, don’t worry — you’ll be drinking plenty of it in a few months when your baby keeps you up all night!

For more information on caffeine amounts in different types of beverages, visit the Center for Science in the Public Interest (cspinet.org/new/cafchart.htm).

All content on this Web site, including medical opinion and any other health-related information, is for informational purposes only and should not be considered to be a specific diagnosis or treatment plan for any individual situation. Use of this site and the information contained herein does not create a doctor-patient relationship. Always seek the direct advice of your own doctor in connection with any questions or issues you may have regarding your own health or the health of others.

  • By Lisa Milbrand

Can I Drink Decaf Coffee While Pregnant?

Pregnant women must make certain sacrifices over the course of their 9-month pregnancy. For example, having a few glasses of wine as you eat Tuna Sashimi are strongly discouraged by doctors and the medical community as alcohol and raw fish can negatively affect the health of the fetus.

Consuming caffeinated beverages while pregnant has long been considered taboo, but is it really?

Is Caffeine Bad for Pregnant Women?

In the 1980’s, the Food and Drug Administration issued a warning about pregnant women drinking caffeinated products. This study was based upon testing they performed by giving various dosages of caffeine to lab mice. The animals showed increased rates of birth defects, still births, and miscarriages when given caffeine while pregnant.

The FDA concluded if caffeine is bad for pregnant animals, it must be bad for human beings.

As far as medical studies are concerned, the FDA experiments on pregnant lab mice are as far as it goes. This is because it is not ethical to give pregnant women drugs (including caffeine) to study the results. So, while lab mice may have an increased miscarriage rate, it’s not 100% conclusive proof that pregnant human beings will react the same.

Caffeine (just like nicotine or alcohol) is a drug. It will get into your blood stream, cross the placenta and even be present in your breast milk. It will put a strain on your liver, which is already maxed out processing the increased hormones your pregnant body is producing.

It has been stated that caffeine has the biggest chance to cause pregnancy complications when you’re in your 1st trimester of pregnancy. This is the critical point in time when the fetus is developing. Adding any sort of drug (that is not prescribed by your doctor) is not a good thing to do.

Actual medical studies have been inconclusive. A study by the State Department of Health and UCSF found no significant increase in birth defects, spontaneous abortions or miscarriages amongst women who consumed caffeine daily. Women who self-reported as “heavy caffeine consumers” (3 or more cups daily) did however have a slightly increased miscarriage rate of around 1.3x the normal rate.

How Much Is Too Much Caffeine?

The general rule of thumb is that caffeine can cross the placenta and will also appear in breast milk. It is also thought that caffeine metabolizes much slower when you’re pregnant and as a result the caffeine blood levels will remain high, even if your consumption is decreased.

Most doctors will suggest that caffeine should be cut out of your diet completely. If you absolutely must have caffeine daily, then limit your daily intake to less than 200mg. Over 300mg of caffeine consumed daily is considered “high”. There have been several medical studies that have shown that over 300mg per day has a statistically increased chance of causing one or more pregnancy complications.

An 8-ounce cup of brewed coffee contains approximately 95mg of caffeine and an 8-ounce cup of brewed tea contacts around 47mg. A 12-ounce caffeinated soda contains around 33mg of caffeine.

There is no set standard for decaf coffee, as it can contain anywhere from 3-18mg of caffeine. Ideally you would read the label prior to consuming, but the waitress in the restaurant you’re in might not know the caffeine amounts in their decaf coffee.

What is Decaf Coffee Exactly?

When most people hear the words “decaf” they automatically assume the liquid beverage is nothing more than coffee-flavored water without caffeine. That’s not exactly true.

Decaf coffee comes from caffeinated coffee beans. The caffeine is removed by a process called the Swiss Water Method. Coffee is soaked in a green coffee extract (that is caffeine free). The caffeine inside the coffee will seep out of the beans after a period of time. At this point the coffee beans are then dried and sold.

This way the flavor of the beans remain and the only thing missing is the caffeine…kind of.

The Swiss Water Method will not remove 100% of the caffeine. This means that the average cup of “decaf” coffee will contain anywhere from 3-18mg of caffeine.

Can Pregnant Women Safely Drink Decaf Coffee?

Studies have shown that women who drink a “moderate” amount of caffeinated beverages while pregnant have an increased risk of miscarriages. This means that even 1 cup of decaffeinated coffee per day could potentially increase the risk of miscarriage.

The problem with these studies is that not all women’s bodies are the same. What could negatively affect one person, might not affect another. Over 300mg of caffeine per day compared to less than 100mg per day showed a “slightly elevated risk” of miscarriage.

Another factor is the actual amount of caffeine in your cup of decaf. There is no set standard and each coffee maker is different. The caffeine amount from batch to batch of decaf beans could also vary widely. While one person may be getting 3mg of caffeine in that cup of decaf, someone in a restaurant on the other side of town might be getting 10mg in their cup.

While the medical studies are a bit murky at best, it can be said with reasonable certainty that consuming any amount of caffeine while pregnant does carry an increased risk of pregnancy complications. It’s probably best to avoid caffeine for 9 months on the off chance something could go wrong.

Just because the studies are inconclusive doesn’t mean you are in the clear to drink decaf coffee. Caffeine is a drug, and consuming drugs while pregnant (unless specifically prescribed by your doctor) can only serve to increase the risk of something going wrong.

Is that really something you want to subject your baby to?

Do You Really Have to Quit Coffee When You’re Pregnant?

Ahhhh, a morning cuppa Joe. Warm, relaxing, soothing, with a little pinch of milk and sugar…isn’t coffee the best? Like the 80s Folgers coffee commercials said, “The best part of waking up is Folgers in your cup.” It’s hard to give up your caffeine vice, especially if you’ve been a coffee drinker for decades.

But wait—can you still have coffee if you’re pregnant?! Is caffeine safe for a baby in utero? Or a mom-to-be? Put down your favorite mug (Oh come on! You know you have one) and listen carefully—no matter how tired and grumpy you are from sleeping on your side all night.

More: Can You Drink Kombucha While Pregnant?

“You do not have to completely quit caffeine when you are pregnant,” says Dr. Danielle M. Barrow, OB-GYN at ProMedica in Toledo, OH. “The American College of Obstetricians and Gynecologists (ACOG) states that moderate caffeine consumption (less than 200mg/day) does not appear to be a contributing factor to miscarriage or preterm birth.”

Cutting back is recommended

Dr. Barrow adds that caffeine’s relationship to fetal growth restriction is unclear. Thus, it may be in your favor to cull the caffeine a little when pregnant. “Due to conflicting conclusions from numerous studies, the March of Dimes states that until more conclusive studies are done, pregnant women should limit caffeine intake to less than 200 mg per day; an average cup of coffee has 100mg of caffeine,” explains Dr. Barrow. “This is equal to about one 12-oz. cup of coffee.”

Since research is skill kind of “scatty” (for lack of a better word) regarding the caffeine/pregnancy connection, Dr. Barrow recommends limiting yourself (if not able to eliminate) to 1 to 2 caffeinated beverages per day when pregnant.

“I would especially limit intake in the first trimester when all the fetal organs are forming, or if the patient has a history of multiple first trimester losses,” she adds.

For more tips during the first trimester, check out our Pinterest board:

Before you succumb to your pumpkin spice latte craving this fall, check out this guide for what to order when pregnant at your favorite coffee chains.

A Pregnant Woman’s Guide to Drinking Coffee at the Major Chains

Since its recommended to consume only 200 mg of caffeine per day, you might need to find some alternatives to your favorite drink at Starbucks, especially when your afternoon exhaustion kicked in.

UK-based writer Emily Meachen “totally relied” on her 7:00 a.m. Starbucks Grande Latte to become—in her words—”humanly functional before rolling into work.”

“I always knew lack of caffeine consumption was going to be one of many challenging aspects of pregnancy,” says the mom. “I tried several alternatives, however for me Yerba Mate (an herbal tea) was the only one which really hit the spot. It tastes great, gives you a similar buzz to coffee without the shakes and crash, and I love it so much I still drink it regularly 2 years after giving birth.”

Manhattan mom Allysa H. was, at one point, “addicted” to Starbucks coffee. “Once I got pregnant, I ordered a half-regular, half-decaf Grande in a Venti cup so it felt larger than it was.”

Dr. Barrow thinks Allyssa’s pre-natal Starbucks choice was a good one. “Try half hot milk and half coffee—maybe even decaf or half caf—if anything; you will get a little extra calcium.”

Other Starbucks drinks that are safe for pregnant women:

  • Frappuccino drinks are mostly safe, with the exception of the Espresso Frappuccino, which has a higher caffeine value. Some of them, such as the vanilla bean creme, do not have any caffeine at all.
  • Iced coffee (tall or grande size only)
  • Iced teas range from 15 to 90 mg of caffeine depending on the type and size. Bonus: you can have the trenta size!
  • Refreshers – Stick to the orange or lime flavors as the hibiscus is not recommended for pregnant women.
  • Smoothies
  • Steamers – Since it’s just milk, it is a perfectly safe option. Add any syrup flavor for an extra kick!

Dunkin’ Donuts

The easiest substitute you can make is to simply swap your hot coffee size to a small. The small original blend and dark roast coffees are under the recommended 200 mg daily caffeine intake.

Other Dunkin Donuts drinks that are safe for pregnant women:

  • Espresso has 75 mg of caffeine per shot. You might consider a shot on its own, or a latte or cappuccino. It is recommended to stick to the small and medium sizes.
  • Dunkaccino – All sizes (small through extra large) are safe since it is half hot chocolate, half coffee.

More: Top 9 Foods and Beverages to Avoid While Pregnant

Peet’s Coffee

If you’ve got a craving for a cup of Peet’s coffee, but don’t want the caffeine, consider ordering it decaf. I know … the idea of decaf coffee is considered a sin to some. You can also try ordering your typical Peet’s drink half caf.

For Peet’s, you can follow many of the rules that apply for Starbucks. Simply try to swap out the amount of caffeine (half caf), the size, or try a non-caffeinated beverage.

Caribou Coffee

At Caribou, simply downsizing your morning coffee to a size small won’t cut it. A small cup of Caribou coffee contains 230 mg of caffeine. It’s best to stick to a small specialty espresso drink like the White Berry Mocha or Turtle Mocha. Most of these are under 200 mg.

Other drinks to consider at Caribou:

  • Hot Chocolate
  • Cappuccino
  • Macchiato

It’s important to note that the Depth Charge is a highly caffeinated beverage containing both coffee and espresso. Cross this one off the list if you are pregnant.

Other Coffee Alternatives You Can Make at Home

“Try some hot water with lemon” and, according to Dr. Barrow, “you will at least be able to continue the habit of holding a steaming hot mug in the morning.”

“When I was pregnant with my second child and wanted to cut back on my caffeine intake, I would drink hot water at work in my Starbucks ceramic mug,” says Coldwater, Ohio mom Rachel Stephens. “With morning sickness, many flavors made me queasy, including hot cocoa. The feel of drinking from a warm mug helped curb my cravings and the hot water soothed my stomach from nausea.”

Fitness instructor and new mom Taylor Walker of Miami, FL, consumed “at least two cups of coffee per day prior to my pregnancy.” Since its recommended to consume only 200 mg of caffeine per day, she had to find other alternatives, especially when her afternoon exhaustion kicked in.

With the OK from her doctor, Walker turned to Premier Protein Clear, which has 90 calories and 20 g of protein, as one of her coffee alternatives. “I loved this drink because it is a safe and effective way to both hit your hydration and protein goals,” she explains. “As my pregnancy progressed, I was drinking a ton of water but found myself getting bored trying to drink 70 oz of water per day. Clear Protein drinks were a great alternative. Since I worked out until the last stretch of my pregnancy, I enjoyed this drink as a post-workout recovery aid.”

Walker also recommends raspberry leaf tea to expectant moms, “which is chock-full of vitamins and minerals and is said to help strengthen the uterine walls and speed up labor. I had a drug-free water birth and my labor from early labor to delivery was less than 12 hours. So, I think it definitely helped and it was a great alternative to coffee in those final few weeks.”

Overall, when cutting back on your coffee while expecting, consult with your doctor on drink alternatives and remember, says Dr. Barrow, that caffeine is in many things, including chocolate and root beer.

As for Dr. Barrow herself, she didn’t totally ditch her morning cup of coffee when preggo. “I chose to limit myself to my one cup of coffee that I like to have in the morning. Outside of that, I stuck with drinking mostly water.”

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Caffeine in pregnancy: Why even decaf coffee could harm your baby

It may be advisable to avoid caffeine all together when you’re expecting, according to a new study – meaning that even a decaf coffee or bar of chocolate may be off the menu for mums-to-be.

Although resources such as the World Health Organisation, American Pregnancy Association and the UK’s National Health Service (NHS) advise limiting caffeine intake to under 200mg daily during pregnancy (around one to two cups of coffee a day), increasing numbers of scientists believe that there is actually no safe limit of caffeine consumption for pregnant women.

The Norwegian study of more than 50,000 women, published this year in the British Medical Journal, found that any caffeine consumption during pregnancy – even that within the current recommended guidelines – is associated with a higher risk of childhood obesity.

Caffeine – a central nervous system stimulant – passes rapidly through the body, including the placenta, and takes longer to process during pregnancy.

The researchers on the Norwegian study believe that caffeine in utero may change ‘fetal programming’ and modify the overall weight growth trajectory of the child.

This study is the latest in a series of papers over the years that have highlighted the negative impact caffeine can have on pregnancy, which at high levels has been linked with an increased risk of miscarriage and restricted fetal growth.

However, this is the first study to have also looked at the impact of low, rather than only high, maternal caffeine intake on children, and is significant because of the implications for the current official guidelines.

“I would agree with the statement that there is no safe level of caffeine consumption during pregnancy,” says Alexandra Chaston, head nutritionist at UAE-based hotel The Retreat, The Palm Dubai.

“As caffeine is a stimulant it may increase your blood pressure and heart rate, both of which are not ideal whilst pregnant. Caffeine is also a diuretic, which means it can cause a loss in body fluids in frequent urination and result in dehydration.

“I would advise to err on the side of caution and avoid drinking caffeinated drinks all together if struggling to get pregnant and when pregnant.”

You may also be interested in: ‘Food safety in pregnancy: The five kinds of bacteria pregnant women should watch out for’

Since decaf coffee – often thought of as the safe option for expectant women – still retains some caffeine after the decaffeination process, its safety for pregnant women is now in question, as well as other caffeine-containing food and drinks such as chocolate, black tea, green tea, some soft drinks and some over-the-counter medications.

“Although studies have remained generally inconclusive on decaffeinated coffee and its link to miscarriages, I would still advise avoiding it during pregnancy,” says Chaston. “Partly because some caffeine still remains in the coffee after the decaffeination process, but also because decaffeinated coffee contains two other stimulants; theobromine and theophylline, which are not removed when the coffee is decaffeinated.”

The amount of caffeine left in decaffeinated coffee can also vary drastically depending on the brand, the process used and the type of bean, so it’s not always possible to be sure of exactly how much you’re consuming.

It’s not just women who are affected by caffeine, adds Chaston. Research has also shown caffeine can affect sperm health such as count, motility and abnormalities, meaning it may be advisable for both partners to cut out caffeine when trying to conceive.

But, with so many of us relying on our morning cup of tea or coffee to get going in the morning, Chaston has some advice:

“For those who are heavy coffee drinkers, I wouldn’t recommend stopping it cold turkey as you are likely to get unpleasant withdrawal symptoms. I would recommend weaning yourself off the caffeine slowly, reducing a cup per day, and substitute your coffee with a decaf or herbal tea – to gradually coming off caffeine altogether within approximately weeks.

“Herbal teas such as ginger, dandelion tea, peppermint tea, nettle tea and Rooibos tea are good substitutes to coffee and black tea as they are nourishing and satisfying without the depleting effects of caffeine. I advise you speak to your nutritionist, naturopath or herbalist if you have any concerns on which teas are safe to drink whilst pregnant.”

You may also like: ‘Countdown to birth meal plan: 6 essential nutrients to prepare your body for labour’

Details

In the study, all levels of caffeine intake were associated with an increased risk of obesity in the child, although the risk was greatly increased for pregnant women with a high caffeine intake compared to a low caffeine intake.

Very high caffeine intake was defined as 300mg or more per day

High caffeine intake was defined as 200–299mg per day

Average caffeine intake was defined as 50-199mg per day

Low caffeine intake was defined as less than 50mg per day

Guide to the caffeine content of food and drink

Brewed coffee (235ml): 95-165mg

Instant coffee (235ml): 63mg

Decaf brewed coffee (235ml): 2-5mg

Decaf instant coffee (235ml): 2mg

Latte or mocha (235ml): 63-126mg

Black tea (235ml): 25-48mg

Decaf black tea (235ml): 2-5mg

Green tea (235ml): 25-29mg

Cola (235ml): 24-46mg

Dark chocolate (100g): 43mg

Milk chocolate (100g): 20mg

White chocolate (100g): 0mg

Source: Mayo Clinic and USDA

‘What to eat (and NOT eat) when you’re expecting’

‘Can you justify eating for two when you’re pregnant?’

‘Do pregnancy cravings carry a secret meaning?’

Coffee, wine, cheese: How much can pregnant women have?

Pregnant women face a lot of dos and don’ts when it comes to food and drink, as in other areas of life. Working out where to draw the line is not always easy – though having a good head for statistics can help.

“When I first found out I was pregnant, I really wanted to have a cup of coffee. It was first thing in the morning. And then I thought all of a sudden, ‘Oh my gosh – am I even allowed to have one cup of coffee?'” recalls Emily Oster, an associate professor of economics at the University of Chicago.

She turned to the internet and found, not surprisingly, that there was no consensus. Then she found that even books disagreed… and her doctor didn’t always agree with the books.

Some writers said pregnant women should avoid coffee completely. Others advised drinking no more than two cups. Yet others drew the limit at three.

“I’ve read books that said six. And so I felt like there must be an answer to this,” says Oster.

“The answer isn’t both zero and six. Surely there is an actual number in here, and I wanted to try to understand both why there’s so much disagreement but also really what is the right decision.”

Using her statistical training, Oster decided to review the medical literature herself.

It is fine to have two cups a day, she concluded. But she describes herself as “more of a two-to-four cups a day coffee lady” – and at this level, she says, the evidence appears to be mixed.

“Early on I felt terrible, and I was not really able to have any coffee which was very sad for me, but once I got into the second and third trimester and I was feeling better, I often had three cups a day and I felt comfortable with that.

“When you look at more – at six or eight cups of coffee – there is some more evidence that that might be risky.”

Oster, now the proud mother of a healthy two-year-old girl, has gathered together her work in a book, Expecting Better. She hopes that where the evidence is mixed, readers can consider the facts and make their own decision, based on what they are personally comfortable with.

It is difficult to draw firm conclusions, she says, because most of the studies are not randomised – it wouldn’t be fair to divide pregnant women under study into two random groups and ask one group to drink coffee and the other to drink none.

Consequently, Oster says, the people involved in the studies differ in many ways that could affect the course of their pregnancies, not just in their coffee-drinking habits.

“The big issue is that caffeine consumption correlates very strongly with how nauseous you are. A lot of pregnant women are very sick, especially early on – the women who are sicker tend to drink less coffee.

“But we know that being sick is a sign of a healthy pregnancy. And so when we see that women who drink less coffee also have more successful pregnancies we don’t really know if that’s just about coffee or whether it’s really a confounding factor from this nausea.”

But coffee was just one item on a long list of forbidden, or semi-forbidden, items that Oster wanted to investigate.

Alcohol for example.

Some health services, like the National Health Service in England, recommend that women avoid alcohol altogether in pregnancy, but Oster says she decided that on the available evidence, she felt comfortable having three glasses of wine – in total – in the first trimester, and then half a glass three or four times a week in the second and third trimester.

“One thing that comes out very quickly, which is very important to emphasise, is that heavy excessive drinking in pregnancy is very dangerous. That’s something you see very clearly in the data.,” Oster says.

“But when I looked at the evidence on having an occasional drink – a couple of drinks a week maybe in the first trimester, up to a drink a day in later trimesters – I found that the evidence suggests that is safe.

“We don’t have large randomised trials, but we do have a lot of high-quality studies which show that the children of women who drink occasionally have very similar outcomes to the children of women who abstain.”

This is not the view of the UK’s National Health Service.

Dr Vivek Muthu, director for healthcare at the Economist Intelligence Unit and chief executive of the healthcare evidence consultancy, Bazian, says the evidence suggests that even a low alcohol intake can risk damaging the developing foetus.

“Therefore the best and simplest advice which the NHS gives out is not to drink at all,” he says.

And while the risk of damage might be lower the less alcohol the pregnant mother drinks, that doesn’t mean, Muthu says, that the magnitude of the damage will be lower.

“The consequences could be just as bad as with higher levels of intake, and could result in permanent and severe physical and mental disability,” he says.

He adds: “There are additional difficulties around defining from the evidence what a ‘low intake’ would be in terms of units of alcohol, and how this might be interpreted by different people in practice.”

But of course there are many other things pregnant women are told to avoid.

“One of the things I found overwhelming about the food list was that it was just so long,” Oster says.

“There were so many things to not eat. I was carrying it around trying to sneak it out during lunch so people wouldn’t know I was pregnant. What I came to think was, ‘Look I need to understand why these foods are restricted, so I can at least have some sort of framework for understanding what’s really going on.'”

Image caption Maybe the fig would be OK…

Oster reviewed the last 15 years of data from the US Center for Disease Control on listeria outbreaks.

The evidence on unpasteurised milk and cheese was clearer than on other “banned” foods, Oster says.

“I found that about 20% of those outbreaks can be linked to unpasteurised cheese; about 10% to deli turkey. But there’s one outbreak linked to ham; there’s one outbreak linked to cantaloupe ; one outbreak linked to celery; one to beansprouts – there are many things like this. And I came to think for a lot of these things there’s kind of no way to predict.

“So I decided that on the occasion when I wanted ham, that was OK.”

Much of the information pregnant women receive is over-simplified in Oster’s view. Doctors just don’t have time to explain things in detail, and help patients think through the decisions.

“And so I came to think that maybe it’s time for women to understand these decisions – really think through the details carefully for themselves – and that that will ultimately improve the quality of medical care,” she says.

“Then you can come into your doctor and say, ‘Look, now I understand what’s going on, let’s talk about how this applies to my particular situation.'”

That, she says, is when “really productive conversations” can happen.

Caffeine During Pregnancy

Caffeine is one of the most loved stimulants in America. But you may need to forego 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 cannot. Your baby’s metabolism is still maturing and cannot fully metabolize the 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.

Fact or Myth?

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.

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 March of Dimes states 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.

Statement: A pregnant woman should not consume ANY caffeine.

Facts: Experts have stated that moderate levels of caffeine have not been found to have a negative effect on pregnancy. The definition of moderate varies anywhere from 150 mg – 300 mg a day. The APA suggests avoiding caffeine as much as possible during pregnancy & breastfeeding.

How much caffeine is in your favorite drinks & snacks?

How much caffeine is too much?

The less caffeine you consume, the better. Some experts say more than 150 mg of caffeine a day is too much, while others say more than 300 mg a day is too much.

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.

More helpful articles:

  • Caffeine Intake During Pregnancy
  • 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. March of Dimes

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.

Shamers keep coming for pregnant women’s coffee. Science roasts their reasoning

Sonja Haller USA TODAY Published 4:08 PM EDT Jun 4, 2019 Pregnant women are fuming about baristas questioning whether they should order drinks with caffeine or coffee shop customers snatching their coffee away. Getty Images

So many small pleasures are snatched away when you’re pregnant.

Sleeping on your belly. Sleeping through the night without waking to pee. Wine. Fitting into stylish shoes or clothes.

Then they come for your cup of coffee?!

Moms-to-be have made headlines recently for coffee shaming incidents as baristas and coffee shop customers pour out medical advice.

In one case, comedian Tiffany Stevenson took to Twitter to share “an unbelievable bit of womb-bothering” when she said she witnessed a Starbucks barista in the U.K. ask a pregnant woman if she would like her caramel macchiato to be decaf.

“No I should because caffeine is bad for the baby,” Stevenson said she overheard the barista say.

A Starbucks spokesperson told USA TODAY that an uninvolved listener caused a misunderstanding and that its policy “is to display drinks and ingredients and to help customers make their own decisions about what to order.”

Another thread had Reddit buzzing when a pregnant woman shared on BeyondtheBump that a “grandma” had snatched and threw away her cold brew coffee. “Is this grounds for murder?” the woman who identifies herself as Counting Ravens joked, explaining she was tired, grumpy and massive.

She tells the tale of letting the customer know that one cup was acceptable, but “grandma” insisted she didn’t drink it.

These are just two examples, but pediatrician Tanya Altmann says that it happens ALL THE TIME and that it happened to her when she was pregnant.

So are these bystanders really looking out for baby, or are they just being jerks?

Dr. Altmann gives us the facts about caffeine and pregnant women.

“Mixed data” on caffeine and pregnancy

Altmann, who practices at Calabasas Pediatrics Wellness Center, said she was questioned with her second of three sons at a coffee shop.

In fairness to well-meaning grandmas or baristas, there is “mixed data,” on caffeine and pregnancy, Altmann said. But respected sources, like the American College of Obstetricians and Gynecologists agree that a moderate amount of caffeine intake, or 200 milligrams a day is best for pregnant women. This is about the amount in a 12-ounce cup of coffee.

“One cup of coffee is perfectly OK”

Altmann said she tells pregnant and breastfeeding women that “one cup of coffee is perfectly OK.”

She does warn women, however, to weigh their coffee intake against food and drink that also may contain caffeine such as sodas, chocolate, dark chocolate and tea.

Finally, Altmann says more than saying no to coffee, pregnant women should consider saying yes to foods that will serve their health and their baby’s health such as food high in calcium, omegas, folate and vitamins.

“There’s so many things that pregnant women should be saying yes to, instead of no all the time,” Altmann said.

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Published 4:08 PM EDT Jun 4, 2019

Can You Drink Coffee While You’re Pregnant?

A cuppa, java, a cup of joe, your daily dose of magic…whatever you call coffee, if you’re someone who relies on at least a cup of coffee or two to power you through the day, you may be dreading the thought of giving it (or any other caffeine) up now that you’re pregnant.

Here’s more on whether any caffeine or coffee is safe during pregnancy, and if so how much.

Can pregnant women drink coffee?

Yes, pregnant women can drink coffee if they want to in moderation. The good news is that you no longer have to kick your caffeine habit completely once you’re expecting a baby. While in the past, pregnant women were advised to avoid coffee and other forms of caffeine entirely, newer, more recent research has found that moderate amounts are safe, as long as you take a few precautions.

How much caffeine is safe during pregnancy?

Current guidelines from the American College of Obstetricians and Gynecologists (ACOG) and other experts say that it’s safe for pregnant women to consume up to 200 milligrams of caffeine a day, or around one daily 12-ounce cup of coffee.

More than that may slightly increase the risk of miscarriage, though the existing evidence is inconclusive. But because caffeine can permeate the placental barrier, most doctors recommend sticking firmly with the 200-milligram limit.

What if you’re not a coffee fan — but you love a morning cup of tea? The amount of caffeine per serving will vary from substance to substance, but here are some general guidelines:

  • 8 ounces of brewed drip coffee: 137 mg

  • 8 ounces of brewed tea: 48 mg

  • 8 ounces of an energy drink: 100 mg

Keep in mind that caffeine is also found in chocolate and soda. And while it’s not necessary to give up caffeine entirely while you’re pregnant, you’ll want to be mindful of how much you’re consuming. It can be helpful to read labels and look at nutritional data from your favorite coffee chain to see how much caffeine is in an actual serving, since it can vary depending on the drink.

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How does caffeine affect my baby when I’m pregnant?

It’s a little unclear. Experts know that caffeine can cross the placenta, but beyond that, research on the effects has been inconclusive, which is why experts recommend sticking to 200 milligrams or less.

How does caffeine affect me when I’m pregnant?

You may find it doesn’t affect you at all. On the other hand, it’s possible that you may react differently to caffeine once you’re pregnant.

Coffee in particular is a diuretic, so if you already find yourself running to the restroom, you may want to put coffee on the “do not drink” list until baby makes his arrival.

And whereas you once would have been able to down three cups of coffee a day without issue, you may now find that even one small cup worsens your heartburn or gives you the shakes or jitters. Some women also find the taste changes during pregnancy.

One note of caution: It’s possible that too much caffeine during pregnancy can impact your body’s ability to absorb iron, which can increase your risk of iron deficiency or anemia. If you already suffer from low iron levels, you may want to cut caffeine out entirely while pregnant. Talk to your doctor if you’re concerned.

Are there any benefits of caffeine during pregnancy?

Generally, moderate amounts of caffeine have been shown to improve energy and alertness, and it can also perk you up after a night spent tossing and turning. The key is to keep an eye on how much you’re drinking a day.

How much caffeine is in tea vs. coffee?

Tea tends to have less caffeine than brewed coffee (which tends to have more caffeine than a latte or other specialty coffee drinks). The chart below will give you a better idea of how much caffeine is in different drinks:

Coffee:

  • 8 ounces of brewed coffee: 95 to 165 mg

  • 8 ounces of brewed decaf coffee: 2 to 5 mg

  • 1 ounce espresso: 47 to 64 mg

  • 1 ounce decaf espresso: 0 mg

  • 8 ounces instant coffee: 63 mg

  • 8 ounces instant decaf coffee: 2 mg

  • 8 ounce latte or mocha: 63 to 126 mg

Tea:

  • 8 ounces of brewed black tea: 25 to 48 mg

  • 8 ounces of brewed decaf black tea: 2 to 5 mg

  • 8 ounces of brewed green tea: 25 to 29 mg

Energy drinks and soda:

  • 8 ounces of an energy drink: 27 to 164 mg

  • 8 ounces of cola: 24 to 46 mg

  • 1 ounce of an energy shot: 40 to 100 mg

Because caffeinated tea has less caffeine than coffee, if you’re someone who enjoys the ritual of making your daily caffeine run and holding a hot mug in your hands, you might find it helpful to switch from coffee to tea. While one 8-ounce cup of coffee will put you at close to the 200 mg limit, an 8-ounce cup of black tea only has 50 mg, meaning you can enjoy two without going over the recommended amount.

Tips for cutting back on caffeine during pregnancy

Since it’s always best to err on the side of caution when you’re expecting, consider cutting back caffeine to one or two (small) cups a day at most. If even that sounds daunting, here are some ways to make the process a little easier:

  • Figure out what you love best about your caffeine fix. Is it the taste of coffee you crave? That’s easy — switch to a quality decaf brew and enjoy the flavor without the caffeine (even espresso comes decaf). Can’t sparkle without carbonated sodas? Turn instead to sparkling water, sparkling juices or sparkling caffeine-free sodas, but in moderation if they’re full or sugar or artificially sweetened. Are you addicted to caffeine’s energy kick? Get a healthier energy boost from a snack of complex carbohydrates and proteins (you’ll get both from cheese and crackers or dried fruit and nuts), exercising regularly (even a 10-minute walk will give your energy level a jolt), and getting enough sleep (but not too much, which can actually make you more tired).
  • Know where it’s hiding. Obviously, it’s in the latte. And the iced Americano. And even the English Breakfast. But did you know that caffeine’s lurking in plenty of sodas, energy drinks, and chocolate- and coffee-flavored yogurt and ice cream (in smaller amounts)? When counting up the caffeine in your day, make sure you add in all its sources.
  • Go gradually. Going from six cups to zero in a day will shock your system — and leave you exhausted, cranky and headachy (the last thing you need on top of pregnancy fatigue). So shoot down those cold turkey plans — and take a gradual approach instead. Start by cutting down one cup a day until you’re at the two-small-cups-a-day mark (or keep going if you’d like to be completely caffeine-free). If even that seems like too much too fast, stick with the same number of cups, but substitute decaf for half of each cup (you can keep the other half regular), and then slowly weaning yourself off both the taste and the kick of the real stuff by reducing the amount of regular and increasing the amount of decaf. Before you know it, your cups will be much lighter on the caffeine and within the appropriate limits for pregnancy. Another way to lower your intake is to make your own latte. Cut the coffee back to half a cup, and fill it to the brim with hot milk.
  • Find energy the old-fashioned way. Eating smaller, more frequent meals and snacks, which is a good idea when you’re pregnant, anyway — but an especially good idea when you’re decaffeinating your system, will keep your energy up by keeping your blood sugar from dipping. Prenatal vitamins will also help you maintain your stamina without a caffeine fix. Now take that extra four bucks or so you spent on coffee every day (plus the money you spent on the accompanying donut) and put it in an empty coffee cup. At the end of the week, treat yourself (manicure, anyone?)…you earned it!

While the thought of scaling back on yet another staple in your diet may be frustrating, remember that it’s not forever. Soon enough, you’ll be able to drink a few cups a day of your favorite coffee again without worry. And when baby’s born, you’re going to need it!

Is it safe to drink coffee during pregnancy?

Yes, but hold the refills. The American College of Obstetricians and Gynecologists recommends limiting your caffeine consumption to fewer than 200 milligrams (mg) per day. That’s about what you’d get from drinking one 10-ounce cup of Starbucks coffee.

Going over that amount could be risky. Some studies have linked drinking more than 200 mg of caffeine a day with an increased risk of miscarriage and low birth weight. And drinking large amounts of caffeine (eight cups of coffee or more a day) has been linked with stillbirth. More research needs to be done to confirm these links, but it’s a good idea to err on the side of caution when you’re pregnant.

Be aware that the amount of caffeine in your cup of coffee will vary depending on the type of coffee and how it’s brewed. The coffee at a restaurant or coffee shop, for example, can range from about 100 mg for a small (8-ounce) cup to over 400 mg for a large (16-ounce) cup, depending on the brand and the brew.

And remember, decaffeinated doesn’t mean caffeine-free. A 16-ounce cup of brewed decaffeinated coffee typically contains about 12 to 25 mg of caffeine.

If you need a caffeine boost but are concerned about your intake, you might choose a latte (about 75 mg of caffeine). From the milk in a latte you’ll get a little extra calcium and protein – nutrients you need during pregnancy anyway.

Be sure to drink plenty of water during your pregnancy. Milk and 100 percent fruit juices are also good choices.

A beloved beverage that plenty of pregnant women don’t want to give up but worry about? Coffee. That’s because there is a lot of conflicting information and science regarding whether caffeine (in general, not just in coffee) can negatively impact the health of the fetus.

So, we asked ob-gyns and a registered dietitian to help clarify whether mamas-to-be really need to completely give up their morning energy elixir (because let’s be honest, pregnancy can be seriously draining). The verdict, below.

This is how drinking coffee impacts your body (and baby) while pregnant.

Let’s start with your body: Caffeine can increase blood pressure and heart rate, says Women’s Health advisor Jessica Shepherd, MD, an ob-gyn and founder of Her Viewpoint. For a woman who is not pregnant and is healthy overall, that’s fine and is part of why you feel so alert after a cup of coffee.

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But the issue if you’re pregnant is that high blood pressure is a risk for low birth weight and has even been linked to early delivery, according to the Centers for Disease Control and Prevention (CDC). What’s more, caffeine can cross the placental barrier (the placenta is the organ that provides your baby with oxygen and nutrients), and it’s harder for a teeny, tiny growing fetus to metabolize the stimulant than it is for you to, says Amanda Baker Lemein, RD, a Chicago-based dietitian and WH advisor.

Caffeine is also a diuretic, says Dr. Shepherd, meaning it makes you pee more and, in turn, can dehydrate you. And last time we checked, pregnancy comes with enough bathroom breaks as is.

Don’t get totally freaked out: Most experts agree that it’s the *amount* of caffeine you consume that matters.

The general takeaway from the available research on caffeine consumption and pregnancy is that things get riskier the more you drink.

There is a lot of conflicting research out there, but the general scientific consensus is that consuming more than about 300 milligrams of caffeine daily may increase your risks of pregnancy loss and having a baby with a low birth weight, as the World Health Organization (WHO) concludes—due to those physiological effects that caffeine can have on the baby.

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So the big thing to remember is that you just don’t want to drink cup-on-cup-on-cup of coffee. “There is a question of growth restriction in the fetus with lots of caffeine, but very little data,” explains Mary Jane Minkin, MD, a clinical professor of obstetrics, gynecology, reproductive sciences at Yale University.
Moderate amounts of coffee are likely still safe for pregnant women, says Baker Lemein: “As a pregnant woman and RD, I have certainly not given up my daily cup of coffee and would be so sad to do so.”

What does a *moderate* amount actually look like? Keep coffee intake to about 8 ounces per day; this size generally contains less than 200 milligrams of caffeine. This piece of advice is also backed by the American College of Obstetricians and Gynecologists (ACOG); the organization says that less than 200 milligrams of caffeine per day “does not appear to be” a factor you need to worry about in regards to miscarriage or preterm birth, per a committee opinion.

Of course, other well-respected health organizations offer different recommendations (because nothing can ever be simple, huh?). The WHO, for example, says pregnant women should drink less than 300 milligrams day.

Don’t forget: Caffeine is in many other foods and drinks, too, including these ones:

  • Tea (48 mg per cup)
  • Chocolate (30 mg per bar of dark chocolate)
  • Soda (37 mg in a 12-ounce bottle)
  • Coffee and chocolate-flavored desserts (2 mg in one half-cup of coffee ice cream, for example)

This means you need to keep tabs on your overall caffeine intake—by adding up what you consume in total from all caffeinated beverages and snacks.

Ultimately, you should always speak with your ob-gyn about any caffeine concerns you have, or if you’re just unsure about whether or not what you typically consume daily is safe.

So just go easy on the coffee each day. And if you need a caffeine-free energy boost…

…take care of yourself naturally by prioritizing sleep and eating nutritiously (which, we know, might be super hard right now). “Although coffee is a stimulant and therefore helps keep you awake, the only real way to truly boost energy is through a balanced diet and proper sleep patterns,” explains Baker Lemein.

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Eat enough throughout the day and go for energy-boosting foods (like oatmeal and strawberries, peanut butter and a banana, or hummus and cucumber slices), but without completely stuffing yourself to a brim. Overeating can also tire you out, pregnant or not, says Baker Lemein.

Finally, drink lots of water and get some exercise (but stick to workouts appropriate for pregnant ladies, per your doctor’s recs). Both will help up your energy levels, which just about *every* soon-to-be mom craves big time.

Cassie Shortsleeve Freelance Writer Cassie Shortsleeve is a skilled freelance writer and editor with almost a decade of experience reporting on all things health, fitness, and travel.

Variations in Caffeine Content

In general, 200 milligrams of caffeine is equal to one 12-ounce cup of coffee, but coffee drinkers should be aware that there can be tremendous discrepancies in different brews. For example, a grande 16-ounce Starbucks brewed coffee has 320 milligrams of caffeine.

Eight ounces of caffeinated tea and most 12-ounce soft drinks have less than 50 milligrams of caffeine; 1.55-ounce chocolate bars have less than 35 milligrams, according to information cited in the new report.

The new opinion statement is based on a literature review of recent studies looking at the effects of caffeine on pregnancy. The authors also looked at how caffeine affects risk of intrauterine growth restriction (IUGR) during pregnancy. While there is no definitive evidence that caffeine increases risk of IUGR, more study is needed to better understand this relationship, the new paper states.

Sami David, MD, a New York City-based reproductive endocrinologist and pregnancy loss expert, tells his patients to play it safe when it comes to caffeinated beverages during pregnancy.

“One cup of coffee a day, which is about 8 ounces and has around 100 milligrams of caffeine, or two cups of black or green tea per day is OK,” says David.

Drink coffee while pregnant

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