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Caffeine & Childbirth

The Basics

Caffeine is a chemically addictive drug that stimulates the central nervous system. The most commonly used psychoactive drug in the world, caffeine provides a boost of energy and can elevate mood. Caffeine is also used as a performance enhancer as it can ward off fatigue for a short period. Caffeine is naturally present in coffee beans, some types of tea, cocoa beans, the ilex plant, guarana seeds, and the kola nut. Caffeine is also added to many drinks, foods, and other products that people come into contact with regularly. 

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Caffeine has been shown to negatively affect fine motor skills, sleep, mood, lifestyle habits, and more. Like any drug, level of sensitivity varies from person to person. Some common symptoms of caffeine use include:

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  • increased urination

  • wired or jittery feeling

  • shaky hands

  • rapid heartbeat

  • muscle twitching

  • upset stomach

  • flushed skin

  • agitation

  • headache

  • negative interactions with certain medications

  • cravings/dependency for caffeine

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Well-Known Sources

  • Soda

  • Energy Drinks

  • Coffee & Espresso

  • Tea

  • Chocolate

  • Caffeine capsules

Surprising Sources

  • Medications, including OTC pain relief

  • Niacin (B3 supplement)

  • Ginseng

  • Malodextrin

  • Drinks with health benefits (Yerba Mate, Kombucha)

  • Snack foods (some granola bars and ice creams)

Risks of Caffeine for Reproduction

Despite a high probability for side effects, the FDA recognizes caffeine as generally safe for healthy adults. However, caffeine is listed in Risk Category C for pregnancy. Drugs in this category have been shown to be harmful in animal studies, but not enough human studies exist for the FDA to warn against use for all pregnant people. Recent research on caffeine around the time of pregnancy indicates it is far more dangerous than previously thought. 

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Potential negative outcomes:​

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  • Consuming caffeine while trying to conceive can lower the chance of getting pregnant by 27%

  • Just 300mg a day prior to conception increases the risk of early pregnancy loss by 25-31%

  • Caffeine during pregnancy has been shown to increase the risk of miscarriage and low birth weight

  • Low birth weight can lead to other health concerns, including NICU admission, organ development issues, and more

  • In high concentrations, caffeine has been known to cause partial paralysis of the legs and severe potassium imbalance

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Caffeine safty pregnancy

Limiting Exposure

Because more and more products are adding caffeine to the list of ingredients, taking account of your overall exposure levels can help limit unwanted symptoms and prevent dangerous outcomes.  ​

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The body is most vulnerable to the effects of caffeine during preconception (before any stage of pregnancy occurs) and the process of implantation (very early pregnancy). It should be noted, though, that all drugs are considered teratogens, which are especially dangerous between Day 18-55 of development when the baby’s organs are growing. Most midwives also recommend limiting intake of caffeine throughout the breastfeeding experience. 

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The good news is that you have control over the amount of caffeine you are exposed to and can make lifestyle changes to avoid it altogether if you deem necessary. The bad news is caffeine can be hard to say goodbye to, especially during long work days or when going out socially.

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pregnant cafeine orange county
Pregnancy prenatal caffeine

  • If you're a coffee drinker, try weaning slowly by doing a 75/25 or 50/50 split between decaf and regular. Or cut down to just one regular per day with the remainder being decaf. Keep in mind that even decaf coffee has some caffeine. 

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  • Switch to tea. Though most tea still has caffeine, it typically has around half or less than coffee. Herbal teas are usually decaffeinated. 

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  • If soda is more your style, try switching to the lighter colored citrus sodas instead of darker drinks and cola based sodas.  

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  • Not sure if your food, drink, or medication choice has caffeine? Check the label! It should be clearly indicated, but you may need to look up any ingredients you are unfamiliar with. This comparison chart is a helpful tool as well.  

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  • Caffeine withdrawal is real and can impact your life. If you're making the switch to a caffeine-free life, take it easy and care for yourself well after stopping intake. Eat nutritious foods, drink plenty of water, add in electrolyte-containing drinks (coconut water, real fruit juice, etc.), and make time for naps and extra sleep at night. Exercise can also help curb cravings.

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  • Healthy food and exercise habits can help minimize the need for mood and energy boosting products. Try taking a walk outdoors at lunchtime. And pay attention to your need for naps as pregnancy progresses! Your body and baby may need something other than a jolt of energy. 

Treatment & Resources

Because there are no screenings/tests readily used to ensure safe caffeine levels are maintained in the body, many people do not know they have been exposed to too much caffeine until something bad happens. The best approach for pregnancy is prevention.

 

Count the amount, in mg, of caffeine you consume each day by reading labels (some products list caffeine and some don't) and cross-checking the amount of caffeine in each item. It's currently recomended that pregnant people take in less than 200mg of caffeine per day, which is equivalent to 1 1/2 to 2 cups of coffee. 

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Talking to your midwife or OB/GYN is key if you believe caffeine is affecting your ability to achieve or maintain a healthy pregnancy. Your healthcare provider can offer moral support, education, and ongoing treatment referrals if immediate action is not needed. Midwives may also offer specific dietary and supplementation counseling to support healthy conception, pregnancy, and birth.

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References

Centre for Addiction and Mental Health (2011). Caffeine. Retrieved from https://www.camh.ca/en/health-info/mental-illness-and-addiction-

               index/caffeine

Chemical Hazards Emergency Medical Management (June 26, 2019). FDA pregnancy categories. Retrieved

               from https://chemm.nlm.nih.gov/pregnancycategories.htm

Fallon, S. (2001). Nourishing traditions. Washington, DC:  New Trends Publishing, Inc.

Food and Drug Administration (2018). Spilling the beans: How much caffeine is too much? Retrieved

               from https://www.fda.gov/consumers/consumer-updates/spilling-beans-how-much-caffeine-too-much

Frye, A. (2010). Holistic midwifery: A comprehensive textbook for midwives in homebirth practice (Vol. 1). Portland, OR: Labrys Press.

Lassi, Z. S., Imam, A. M., Dean, S. V., Bhutta, Z. A. (2014). Preconception care: Caffeine, smoking, alcohol, drugs and other environmental 

              chemical/radiation exposure. Reproductive Health, 11, 1-12. doi: 10.1186/1742-4755-11-S3-S6

Macdonald, S. & Johnson, G. (Eds.). (2017). Mayes' midwifery: A textbook for midwives (15th ed). UK: Elsevier.

Photographs courtesy WIX.com, inc. (Owner). (n.d.). [Photograph]. Used with permission.

Weng X., Odouli, R., & Li. D. (2008). Maternal caffeine consumption during pregnancy and the risk of miscarriage: A prospective cohort study.

              American Journal of Obstetrics & Gynecology, 198, 279.e1-279.e8. doi:10.1016/j.ajog.2007.10.803

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