A common question that gets tossed around is “Is it okay to drink coffee when you are pregnant?”.
I myself had this question because working 12-hour shifts as a nurse in an emergency department… you need coffee. Caffeine is the most widely used drug in the world. Yes, I said drug.
It is a stimulant, by definition, any substance that raises the level of physiological or nervous activity in the body. Did you ever look at it that way? Will you consider that the next time you pour your third cup of the day? Me either. Why is that? Because it is the social norm. Coffee is not on the same level by any means as illicit stimulants such as cocaine, but it’s potential effects on our bodies should be assessed especially in pregnant and lactating women.
Across the medical boards, the general consensus for caffeine recommendations in pregnancy is that it is “safe in moderation”. The recommended daily intake ranges from 200mg-300mg. Not sure what that means for you? Well, consider the average cup of coffee contains approximately 100mg of caffeine. So you should limit your intake to 2 cups per day. This means two 8-oz cups, and not 2 Triple Venti Caramel Machiattos from Starbucks. It is important to realize that the concentration of caffeine varies from place to place as well. The difference is due to the coffee beans themselves and how they are subsequently brewed. Therefore, the caffeine intake per cup is actually an estimated range.
Another consideration for you is that caffeine is not just from coffee. It can also be present in tea, soda, sports drinks, chocolate and some over the counter medications. Just be sure to take a look at labels and know what you are putting into your body.
So can I drink coffee while I’m pregnant?
The moral of the story is it is up to you.
There is not enough clear cut evidence either way to determine if it’s safe or not. It is known that caffeine does cross the placenta and reaches your baby. In the third trimester the metabolism of caffeine slows down, meaning it is in the body longer. There is limited information available in terms of causing miscarriages or small birth weights because caffeine is only one factor to consider. There are too many other things that can contribute to negative outcomes in pregnancy to pinpoint it to caffeine being the culprit. I personally cut caffeine out of my diet completely during pregnancy because I feel that due to the lack of scientific knowledge out there it is not worth any potential risk.
What about having coffee if I’m breastfeeding?
Caffeine does get into the breast milk. As quickly as 15 minutes after consumption it can be detected (Nisenbalt & Norman, 2018.). Compared to the maternal blood concentration the amount of caffeine that will be in the breast milk is fractional. Much like in pregnancy there is little evidence to determine either way if caffeine has negative effects. Some people have reported increased irritability and nocturnal wakings with caffeine consumption, but again there are too many other factors to consider when trying to determine if caffeine is really the culprit.
Something to keep in mind, however, is that caffeine will act as a diuretic (you pee a lot more) which can dehydrate you. You need to maintain adequate hydration so it does not impact your milk supply.
Limit caffeine intake to 200-300mg per day.
Recognize other foods and drinks that may contain caffeine other than coffee.
Maintain adequate hydration as caffeine can lead to dehydration.
*resources sited are from UpToDate, an evidence-based clinical decision support resource from Wolters-Kluwer
Nisenbalt, Vicki MD & Norman, Robert J. MD (2018). The effects of caffeine on reproductive outcomes in women.