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Q & A: Is it safe to drink coffee while pregnant?

This is one of the most frequent questions women ask at the beginning of pregnancy: It’s clear that smoking and alcohol are to be stopped, but what about coffee?

Motherisk  is a program ran out of the Hospital for Sick Children in Toronto and helps answer such questions for women who are pregnant or breastfeeding. They recently reviewed available evidence on the thorny question of coffee consumption.

While it’s not exactly clear if there is a direct link when higher amounts are consumed, all evidence shows that at levels of less than 300mg/day (1-2 cups of coffee) there is no increased risk to becoming or staying pregnant, nor to the baby itself. There was neither neurodevelopmental impact nor disrupted sleep patterns in babies of moms who stayed below that level of daily intake. Just be careful as coffee made by a barista can contain almost twice the caffeine of a home-made cup.

So what about that Mother and Child Norwegian study published earlier this year and reprinted by newspapers, alarmingly indicating that the coffee even in small amounts can cause low birth weight and prolonged labor? They did follow almost 60,000 women over 10 years and isolated coffee’s impact from other harms such as tobacco and alcohol. That said they showed that “women whose caffeine intake was 100mg a day (equivalent to ~1 cup) had birth weights of 21 to 28g less than babies of women who didn’t have as much”. If you consider that the North American average is 3.4 kg and most term babies are typically in the range of 2.7–4.6 kg, this difference has no meaning. Nor is the longer pregnancy term that was reported in the papers of any significance - unless you think that 5 to 8 hours longer matter over the 40 weeks of being pregnant! They do have some interesting insights otherwise, so worth a look if you are curious about immunity and autism for example.

Tea has about one third of the caffeine content of coffee and so do cola type drinks.  Decaf coffee has the same amount as hot chocolate - both have about 1/30th of the amount of caffeine contained in a cup of coffee. The thing to consider with decaf coffee and diet colas is the unknown safety of the chemicals used to decaffeinate the coffee or the substances used as replacement for sugar. You should however definitely AVOID sweeteners that contain saccharin and cyclamates such as Sweet ’N Low and Sugar Twin.

And what about herbal teas? While clearly caffeine free, not much has been done to study the safety during pregnancy and breastfeeding of any substances they may contain.  No government body regulates teas and supplements either, so you don’t know what kinds of contaminants may be present. Some have known medicinal properties, such as St John’s wort.

It is generally considered to be safe to have 2-3 cups per day of the following teas: citrus peel, ginger, lemon balm, linden flower, orange peel and rose hip (note: linden flower is not safe if you have a heart problem). Some herbal teas however, such as chamomile for example, while soothing and perceived as harmless are known to be UNSAFE for expecting mothers. Ginger tea seems to be safe as although data on safety of ginger is lacking up to 1000 mg of ginger is taken through normal diet in some cultures, so the recommended dose is up to 1000 mg per day. It can help with nausea and vomiting. You can search the Motherisk website for specific information or send them a question.

And of course if you have ANY questions, be sure to check with your healthcare providers. If they give you any attitude about you asking many questions, the advice I give to all my patients is “Ask away: It’s your body and your baby, and if something bad happens that you wanted to ask about and did not, it will be hard to forgive yourself! Part of our work is not just to diagnose, but also to help you figure our whether something you are concerned is a problem or not.”

The second most common question I get after I answer the first one above is what did I do when I was pregnant and breastfeeding? “Yes” to small amounts of coffee, black, green or ginger tea. Personally, chose a “No” to decaf, artificial sweeteners or other herbal teas. And of course, as recommended - a definite “No” to smoking and alcohol.

Alexandra T. Greenhill, MD, mother of three, CEO and Co-founder myBestHelper

Posted: September 29, 2013