The Great Caffeine Debate

The other day a friend and I were talking about caffeine.  How much is ok during pregnancy?  The popular answer seems to be "next to none".  Women are made to think that they need to give up their morning cup o' Joe if they are expecting.

Hanging out at Starbucks Roastery at 21 weeks

I had always read that 200mg of caffeine, or 2 cups of drip-coffee, per day was acceptable during pregnancy.  And if you were to go over that amount you could be putting your baby at risk for low birth weight, stunted growth, or even have a miscarriage.  Terrifying! No wonder so many preggy mamas are afraid to drink anything with caffeine.

Before I got pregnant, I was a coffee addict. I couldn't live without my morning cup and would often order a "venti soy cappuccino" from the Starbucks near my work for lunch.  After work, I'd either brew another cup of coffee or tea to get through the evenings. That added up to around 350mg of caffeine per day. I was always ON! If I could figure out a way to rig up an IV with coffee, I would have done it!

As my wedding day approached, I knew that my fiance and I would be trying to start a family soon after the festivities. I did some reading up on ways to cleanse my body in order to have a healthy future pregnancy. I read that caffeine can really throw your fertility off-kilter. I knew I had to cut down. I ended up only having my morning cup of coffee and a cup of tea for my afternoon pick-me-up every day.  My Starbucks barista was so shocked at my new order of a "tall Earl Grey with soy" that she asked "Who are you?!" 

The cleanse went well.  I also went on a sugar-fast and gave up certain meds that can affect the implantation of eggs to the uterus, like ibuprofen. I felt so much healthier!

I continued to cut back on caffeine during my current pregnancy. I couldn't stand the taste of hot coffee any more so I swapped that out with only a morning cup of tea, until I got sick of that and had to give up all hot caffeinated beverages completely. I discovered a love for all things ICED! Iced teas and coffees became my obsession! I started getting worried that I was getting too close to that 200mg daily limit with my new iced friends. I asked my doctor about it and she didn't seem concerned at all. She even said that I could go over the 200mg limit.

I was so confused so I decided to do some digging. I searched databases for sound studies that evaluated the use of caffeine in pregnancy. The results weren't as scary as I thought!

Many of the studies show no significant correlation between birth weight/height and caffeine use in pregnancy with moderate consumption (under 300mg/day).  One study even went as far as saying 400mg/day seemed safe according to the study parameters. Another study stated there was a small correlation between caffeine consumption and the risk of SIDS (Sudden Infant Death Syndrome) in babies. However, recent research is showing that SIDS is probably caused by the structure of the ear canal in certain infants. Results are mixed when it comes to caffeine consumption and risk of delayed conception.

So as a pharmacist, what would I tell my patients asking advice on this topic? Caffeine is okay in moderation if you are pregnant unless you have any other medical conditions that may get worse by consuming caffeine. It is important to remember that it is a potent stimulant that can cross your blood-brain barrier and also affect many different organ systems!  It can also cross into the placenta and reach your baby and its developing brain. Your baby is very sensitive to what you put in your body, so if caffeine makes you the least bit jittery, imagine what it can do to your little one! Listen to your body. Often times pregnant women will feel sick with more than one cup of coffee.  That is your body, and baby, telling you to cut back. This is such a wonderful time in your life because you are most connected to your body and your little one right now. If something doesn't feel right, then trust yourself and do what does feel right.

So in love with iced coffee!

I still stick to my 200mg/day limit. Usually, I just do one glass of iced tea a day which has around 40mg of caffeine. As a treat, I sometimes go for a tall iced soy latte from "Le Bucks" which has about 75mg. I still listen to my body to know if I should stop. When I drink "too much" caffeine, I seem to get crampy and nauseous. I think of that as my baby saying "ENOUGH, MOM!"

So all you soon-to-be mamas out there, go ahead and have that cup of coffee if you want, but be sure to listen to your bodies.  =)