Caffeine and Pregnancy

I think it’s pretty well accepted that you should cut caffeine out or drastically reduce it from your daily routine once you are pregnant, but I found it hard to determine how much is really allowed.

  • The American Pregnancy Association says [t]he less caffeine you consume, the better.” and “Avoiding caffeine as much as possible is your safest course of action.”  They do note that experts cite a maximum of 150mg – 300mg as the upper limit of what a pregnant woman should consume daily.
  • Kaiser Permanente says to limit yourself to 1 cup of coffee, which I found unsatisfyingly simplistic.

So, I think airing on the side of caution, a maximum of 150 mg/day is a safe bet.  I made this chart to help mommas-to-be figure out how much caffeine they are consuming every day.  The information comes from the Mayo Clinic unless otherwise noted.

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4 Responses to Caffeine and Pregnancy

  1. sounds like typical pregnancy fear-mongering to me. can you cite some studies that support limiting caffeine intake, and support the limits suggested here?

    http://www.nytimes.com/2008/01/21/health/21caffeine.html talks about one study, but does an uncharacteristically good job (for science journalism) at listing the reasons why one should be skeptical of that study’s conclusions.

    here’s a great article from 2010: http://health.usnews.com/health-news/family-health/womens-health/articles/2010/07/21/moderate-caffeine-intake-safe-during-pregnancy-experts-say

    summary: “even though we have no evidence linking caffeine consumption to any problems, we’re recommending you limit your intake to 1 cup per day”. sigh.

    since the only thing people seem to be worried about – without any hard evidence – is miscarriage even if you believe the studies that argue against caffeine, you probably only need to worry about it in the first trimester.

    i want to see a study that coordinates parental paranoia with pregnancy outcomes. my theory is that bad science-induced stress is a greater risk factor than caffeine, soft cheese, moderate alcohol consumption, etc.

    • I think your word choice of “fear mongering” is really interesting and assumes negative intentions by medical professionals who issue these guidelines. I have a different perspective, which I think is influenced by the fact that I will be the one who is pregnant and what I do is what influences fetal development. To me, it hardly seems like a major sacrifice to limit/give up a few things if there is any chance (I really mean any chance) that it will help my baby’s development, so I welcome the guidelines that are issues by medical professionals. Of course, there is a line – if my doctor told me that I had to eat white bread and water for 9 months, I might look for a different doctor!

      Based on a brief search of several academic databases, I found many studies that link caffeine, alcohol, and tobacco to problems during pregnancy and not just related to miscarriages because they impact fetal development during various stages of pregnancy. The studies I came across focused on different things, controlled for different factors, different amounts of consumption, and found different sized effects. Here is a random list of some (forgive the non-APA citations!):
      Alcohol, drugs, caffeine, tobacco, and environmental contaminant exposure: Reproductive health consequences and clinical implications, Vol. 40, No. 7 , 633-652, August 2010.
      Maternal exposure to tobacco smoke, alcohol and caffeine, and risk of anorectal atresia: National Birth Defects Prevention Study 1997–2003, Paediatric and Perinatal Epidemiology, Vol. 23, Issue 1, 9–17, January 2009.
      Caffeine Consumption during Pregnancy and Spontaneous Abortion, Epidemiology, Vol. 2, Issue 3, May 1991.
      Effects of Maternal Alcohol, Nicotine, and Caffeine Use During Pregnancy on Infant Mental and Motor Development at Eight Months, Alcoholism: Clinical and Experimental Research, Vol. 4, Issue 2, 152–164, April 1980.

      If you would like to do (or find) a thorough literature review, I would be happy to post it. I would be surprised if there aren’t a few theses out there that have already looked at this issue.

      I think alcohol, caffeine, and tobacco are the things that almost certainly will impact your pregnancy if done in great enough quantities because those are substances are that negatively impact fetal development. What is a great enough quantity? I’m sure if you read enough studies, you could figure out at what point risk increases to a point that you personally are uncomfortable with. Bottom line – most women I know aren’t willing to risk it even if the chances are very small.

      With foods to avoid (ie raw fish, unpasturized cheese, cold cuts), it’s more about the potential chance that the food is contaminated with bacteria (usu listeria). So again, if you’re willing to take the risk that the foods you consume aren’t contaminated, then go for it. Again, most women I know aren’t willing to risk the guilt if something did go wrong – rational or not.

  2. you’re right! it’s a pet peeve of mine, and one that i have no right to have since i’m never going to be pregnant. maybe i can find a more personally-relevant form of unreasonable social control to be annoyed with. sorry for being a jerk.

    thank you for the citations!

    IANAL, but i think that by default people should have the right to make their own decision about what risks are reasonable to take during pregnancy, or any other similarly personal decision. limits to a person’s right to make decisions about risk should not be arbitrary, or based on bad science.

    when authorities lay down rules of conduct, without providing enough information for people to make their own choices (such as the american pregnancy association coming up with a limit on daily caffeine consumption) it erodes people’s ability to make those choices.

    my fear is that non-scientific guidelines will eventually be codified into social mores or legal statues, and people who want to make their own, informed, decisions will be bullied, harassed, prosecuted, etc.

    the argument that it’s a small sacrifice to give up caffeine or alcohol, so you might as well do it even if there’s no clear risk makes perfect sense for an individual, but is a bad way to make a law, and resembles the “for the children” or “don’t let the terrorists win” kind of false arguments that have led to a lot of bad policy in the US IMO.

    national advocates for pregnant women has an interesting review of legal efforts to criminalize drug and alcohol use by pregnant women: http://advocatesforpregnantwomen.org/issues/pregnancy_and_drug_use_the_facts/

    some of these laws and related arrests seem kind of reasonable (to me, although not to the NAPW). others, where pregnant women have been arrested and charged with child abuse for having a single drink, are really frightening to me.

  3. I think guidelines are just that – guidelines. I don’t think I said anything that indicated that I supported passing laws based on these guidelines. But, you bring up an interesting point, what do parents owe their children prenatally? Putting aside viability issues, if a child is born with developmental problems that can be linked to actions knowingly taken by the mother, should she be held responsible? During the manufactured crack baby epidemic, many poor, women of color were indeed having their children taken away from them at delivery. But, fertility drugs have actually been shown to have very similar impacts on babies (ie low birth weight, restlessness, developmental delays). Should women who use fertility drugs who have babies with these negative health outcomes be held liable?

    Back to guidelines. Yes, I agree that guidelines should not become laws without input from multiple parties, but fear not because they don’t. There are many opportunities for public input when laws or regulations are being proposed. The cases sited by NAPW seem to be extreme ones and also strangely limited to South Carolina. There are no citations, so I can’t check the cases and there aren’t enough facts provided for me to respond adequately from a legal POV, but for example, the link you provided says a women who gave birth to a healthy baby can be convicted of child abuse. That doesn’t mean she was, that language suggests that in that particular case, the women was not convicted of child abuse, but that the court left open that possibility in some circumstances.

    I don’t doubt that there are cases throughout the country that have outcomes that I personally would find egregious and if there are in fact, laws in South Caroline that make it illegal to drink more than three cups of coffee a day while pregnant, for example, then our democratic processes allow for those who believe this is absurd to do something about it.

    In the meantime, I appreciate having guidelines from an organization with a medical advisory committee that is dedicated to healthy pregnancies. I don’t, despite evidence to the contrary, want to do research about every possible thing that can impact my life. I don’t have time to have to get degrees in that many fields!

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