A Note for the Caffeine Aficionado
Many of us have one morning routine in common: making a delicious caffeinated beverage. Although, while pregnant, changing what or how much caffeine you drink may be one of the first steps you can take to help your baby thrive. This is not black or white - you may have to decrease your overall caffeine intake, but you may also be able to treat yourself with healthier, less caffeinated beverages. We are here to help you navigate.
Why do I need to drink less caffeine during my pregnancy?
Various studies have analyzed the effects of caffeine intake on pregnancy outcomes. Due to the unethical nature of completing studies on pregnant people where there could be potential harm, the designs of the studies are limited.
One review suggests that higher caffeine intake during pregnancy is associated with a higher risk of low birth weight. One study with an actual control group and intervention group, found that there was no significant effect on birth weight or length of gestation with moderate reduction of caffeine in the second half of pregnancy. A larger review states that increased intakes of caffeine are associated with negative birth outcomes, but the amount of caffeine to limit or suggest is unclear. The conflicting conclusions are likely why the current guidelines for caffeine intake during pregnancy remain as follows: people should not exceed 200 mg of caffeine a day while pregnant.
The specific reasons why caffeine can be harmful during pregnancy are not exactly known in all circumstances. What we do know is that due to changes in enzyme activities, the speed of caffeine metabolism significantly decreases during pregnancy. This means that caffeine tends to stay in your system longer. While this caffeine is hanging around in your system it can also pass through the placenta to the baby. At this time in a baby's life, they do not have the ability to properly metabolize caffeine, which can cause the caffeine to stay in their system for long periods of time. In addition, caffeine has also been shown to reduce blood flow in the placenta.
It is also important to note that caffeine can increase your blood pressure and heart beat and lead to dehydration, which is why drinking water or other no (or low) sugar fluids throughout the day is key!
Caffeine comes in a variety of forms
While pregnant, it is recommended to keep caffeine consumption, if any, under 200 mg a day. Below are the caffeine content of various black coffees and teas:
Keeping it under 200
While it may seem easy to keep your caffeine intake under 200mg, it is important to always check to see how much caffeine is in the brand you are using and the amount you are pouring. Here is some advice to lower your intake!
What is safe to add to my caffeinated beverage for a sweet touch?
Adjusting your caffeine routine can be difficult, especially if you are used to curbing your sweet tooth with a vanilla latte. Excessive sugar intake during pregnancy has been linked to multiple pregnancy complications.This doesn’t mean you can’t enjoy a sweet treat, it just means that you should be cautious and consume sugary foods and beverages in moderation.
It may seem that switching to sugar substitutes is a healthy alternative, but there is conflicting data on their safety. This study suggests that intake of artificial sweeteners may increase risk of preterm birth. Some animal studies suggest that artificial sweeteners can negatively alter the gut microbiome. However, according to the FDA, artificial sweeteners such as sucralose and aspartame are safe to use during pregnancy in moderation. Other sweeteners such as processed stevia extract are generally regarded as safe during pregnancy by the FDA (the whole leaf has not been approved as safe for consumption).
If you find yourself reaching for a sweet drink there are ways to slowly wean yourself down. Natural sugars such as white sugar, honey, agave, and maple syrup all contribute to increases in blood sugar. If you use these, try to find the smallest amount that satisfies your sweet tooth. Cutting back on sugary foods (sugar substitutes included) helps to reduce sugar cravings. The more you have, the more you want.
Sending you a whole latte encouragement!
There are many ways to keep caffeine consumption under 200 mg per day. Moderation is key. Whether it is drinking a smaller cup of coffee, making the transition to decaf, or even switching to tea, it is important to make this change early to help you and your baby shine.
Resources:
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Tsutsumi K, Kotegawa T, Matsuki S, et al. The effect of pregnancy on cytochrome P4501A2, xanthine oxidase, and N-acetyltransferase activities in humans. Clin Pharmacol Ther. 2001;70(2):121-125. doi:10.1067/mcp.2001.116495
Rhee J, Kim R, Kim Y, et al. Maternal Caffeine Consumption during Pregnancy and Risk of Low Birth Weight: A Dose-Response Meta-Analysis of Observational Studies. PLoS One. 2015;10(7):e0132334. Published 2015 Jul 20. doi:10.1371/journal.pone.0132334
CARE Study Group. Maternal caffeine intake during pregnancy and risk of fetal growth restriction: a large prospective observational study [published correction appears in BMJ. 2010;340. doi: 10.1136/bmj.c2331]. BMJ. 2008;337:a2332. Published 2008 Nov 3. doi:10.1136/bmj.a2332
Chen LW, Wu Y, Neelakantan N, Chong MF, Pan A, van Dam RM. Maternal caffeine intake during pregnancy is associated with risk of low birth weight: a systematic review and dose-response meta-analysis. BMC Med. 2014;12:174. Published 2014 Sep 19. doi:10.1186/s12916-014-0174-6
Bech BH, Obel C, Henriksen TB, Olsen J. Effect of reducing caffeine intake on birth weight and length of gestation: randomised controlled trial. BMJ. 2007;334(7590):409. doi:10.1136/bmj.39062.520648.BE
Greenwood DC, Thatcher NJ, Ye J, et al. Caffeine intake during pregnancy and adverse birth outcomes: a systematic review and dose-response meta-analysis. Eur J Epidemiol. 2014;29(10):725-734. doi:10.1007/s10654-014-9944-x
Halldorsson TI, Strøm M, Petersen SB, Olsen SF. Intake of artificially sweetened soft drinks and risk of preterm delivery: a prospective cohort study in 59,334 Danish pregnant women. Am J Clin Nutr. 2010;92(3):626-633. doi:10.3945/ajcn.2009.28968
Abou-Donia MB, El-Masry EM, Abdel-Rahman AA, McLendon RE, Schiffman SS. Splenda alters gut microflora and increases intestinal p-glycoprotein and cytochrome p-450 in male rats. J Toxicol Environ Health A. 2008;71(21):1415-1429. doi:10.1080/15287390802328630
Bian X, Chi L, Gao B, Tu P, Ru H, Lu K. The artificial sweetener acesulfame potassium affects the gut microbiome and body weight gain in CD-1 mice. PLoS One. 2017;12(6):e0178426. Published 2017 Jun 8. doi:10.1371/journal.pone.0178426