Is it safe to drink coffee during pregnancy? And what does this mean for chocolate lovin’ mamas?
Pregnant moms frequently ask me if it’s safe to drink coffee during pregnancy, and then tell me how they can’t “survive” without their daily coffee fix, but they’re worried about harming their baby, and are confused about what amount of coffee and caffeine is safe during pregnancy. Read on to see what the research says, what our health care system says, and what this mean for those chocolate lovin’ mamas!!
Caffeine is a Stimulant
Caffeine whether you think it innocent or not, is only one of two stimulant drugs that are present naturally or widely added to foods. (the other one being quinine – more about that below) And is added to drinks and food products because of its addictiveness.
There have always been concerns about the relationship between a mom’s daily coffee habit and the potential effects on her unborn child because caffeine crosses the placenta exposing baby. Most doctors and medical practitioners will probably tell you it’s ok to have a cup of coffee or two per day. But is it really safe?
First the Good News for Chocolate Lovers!!
Did you know that it’s a myth that chocolate contains caffeine? (That was news to me too!) It does however contain theobromine which is an active ingredient in coffee and also occurs in cacao. It is a stimulant and does have a structure similar to caffeine, which could explain why some people believe chocolate contains caffeine. (But also note that some chocolate products do have added caffeine in them.)
The real chocolate; cacao contains healthy flavonoids and antioxidants which are good for our health! This study reported that chocolate consumption may benefit cardiovascular health when it was observed that preeclampsia in pregnant moms was reduced when they consumed 5 or more servings of chocolate per week, compared to another group of pregnant women who only ate 1 serving of chocolate per week. Hooray!!! But before you bust out the KitKat or whatever your chocolate of choice is, make sure you choose the healthiest of chocolate. I’m not talking your standard chocolate bar chocked full of sugar, artificial flavors, GMO oils and sugar, and fillers that you see at the local convenient and grocery stores. I’m talking the real chocolate called cacao that has over 600 healthy chemicals including flavonoids, magnesium, antioxidants, and anti-inflammatory properties.
Here’s what to look for: Look for bars that are made with cacao – the higher % the better. I like 70%, but it took me awhile to get used to the rich flavor. However the upside is that you feel more satiated after eating it than after eating the sugary processed chocolate. Plus it doesn’t leave you craving more. You can easily find these health promoting chocolate bars in the Fairtrade and organic brands sold at specialty and health food stores. My favourite brands are Giddy YoYo (Raw), Camino, and Green & Black’s Organic. However you can also find 70% cacao in more famous brands like Ghirardelli and Lindt, you just have to look for them.
What the studies say about caffeine during pregnancy
This study concluded that caffeine intake was consistently associated with decreased birth weight and increased odds of the baby being small for its gestational age, and reported that caffeine intake of 200 to 300 mg/day increased the odds for baby being small for his or her gestational age.
However, in this meta-analysis recently conducted in August 2015, researchers found that caffeine and coffee consumption were both positively associated with an increased risk of pregnancy loss. Furthermore it suggested that pregnancy loss rose by 19% for every increase in caffeine intake of 150mg/day, and by 8% for every increase in coffee intake of two cups per day.
In another study published in Oct 2014, a similar meta-analyzed report concluded that an increment of 100g of caffeine was associated with increased risk of miscarriage, stillbirth, preterm delivery, low birth weight, and an increase in baby being small for its gestational age. Even after these results, the researchers were unable to determine a threshold below which these outcomes were not apparent, and thus concluded that pregnant women should stick to the current caffeine recommendations during pregnancy.
So what is the recommended caffeine intake for pregnant mamas?
Health Canada recommends that women of reproductive age consume no more than 300mg/day. MotherRisk recommends limiting consumption to 300mg/day or less, which is about 1-2 cups of coffee. In the United States, The March of Dimes recommends 200mg/day which is about equal to one 12oz cup, and if you’re breastfeeding, limit your intake to no more than two cups of coffee per day.
How do you know how many milligrams of caffeine your daily double caffé mocha latte contains?
Click here for a list of popular drinks and snacks published by the Centre for Science in the Public Interest to help you determine if you are within the recommended limits.
Quinine – Is in your tonic water?
Although tonic water does not contain caffeine, most brands contain the other added addictive stimulant quinine. Check the label and steer clear of quinine containing drinks as there have been reports of babies suffering from withdrawal symptoms once born. For mom, there are neurotoxic effects including headache, visual disturbances, and confusion, ringing in the ears, gastrointestinal disorders including nausea, vomiting, and diarrhea among other potential cardiac, and blood pressure, kidney issues that can arise. Because quinine- containing medication is contraindicated during pregnancy (the most popular drugs being treatment for nocturnal leg cramps, and malaria) it should also be avoided in your drinks. I’m disappointed but not surprised there isn’t a warning on quinine containing tonic water saying as much. Recommendations for breastfeeding moms have not been published as it cannot be assessed on the basis of the knowledge currently available, but the American Academy of Pediatrics has stated that it can probably be tolerated during lactation.
I wanna know. What’s your favourite caffeinated beverage, and did you cut it out entirely, or decrease your consumption while pregnant? As for myself, I’m not a huge coffee drinker (maybe once a month), but I do enjoy a green tea every now and again, and I have cut back while pregnant and make sure not to steep it as long as I used to.
References and Sources:
Sweetman SC, 2002. Martindale – The complete drug reference, thirty-third edition, Pharmaceutical Press.
http://www.bfr.bund.de/cm/349/quinine_containing_beverages_may_cause_health_problems.pdf
Mother Risk www.motherrisk.org
Health Canada www.phac-aspc.gc.ca
March of Dimes www.marchofdimes.org