FREE COIN APPRAISAL EVENT 10:00a.m. – 3:00p.m. April 22

Caffeine During Pregnancy and Lactation
Shanae Teuscher
Weber State University
Knowing and understanding the effects caffeine can and may have on the human body is
important, but especially for women during times of pregnancy and lactation. Gaining an
understanding of its possible effects on a mother and her baby will allow each woman to
knowledgeably weigh out the potential risks and benefits, and then to choose for herself what
she’d like to submit her body and baby to.
Caffeine is a stimulant that is naturally produced in the leaves and seeds of many plants
and it is also artificially produced and added to some foods (Black & Gavin, 2008). The
following table shows several of the common beverages, foods, and supplements and the amount
of caffeine that each contains:
Drink/Food/Supplement
SoBe No Fear
Monster energy drink
Rockstar energy drink
Red Bull energy drink
Jolt cola
Mountain Dew
Coca-Cola
Diet Coke
Pepsi
7-Up
Brewed coffee (drip method)
Iced tea
Cocoa beverage
Chocolate milk beverage
Dark chocolate
Milk chocolate
Jolt gum
Cold relief medication
Vivarin
Excedrin extra strength
Source: Article by Black & Gavin, 2008
Amount of Drink/Food
8 ounces
16 ounces
8 ounces
8.3 ounces
12 ounces
12 ounces
12 ounces
12 ounces
12 ounces
12 ounces
5 ounces
12 ounces
5 ounces
8 ounces
1 ounce
1 ounce
1 stick
1 tablet
1 tablet
2 tablets
*denotes average amount of caffeine
Amount of
Caffeine
83 mg
160 mg
80 mg
80 mg
72 mg
55 mg
34 mg
45 mg
38 mg
0 mg
115 mg*
70 mg*
4 mg*
5 mg*
20 mg*
6 mg*
33 mg
30 mg*
200 mg
130 mg
As is indicated, many of the medicines used for pain relief, headaches, migraines, colds, and
deferring sleep contain caffeine.
Although caffeine is widely used and accepted, it is defined as a drug because of its effect
on the nervous system (Black & Gavin, 2008). Generally, an intake of caffeine increases
concentration and puts off feelings of tiredness for a period time (Mahan & Escott-Stump, 2008,
p. 1277). Caffeine intake may also lead to unpleasant long-term effects such as increased body
temperature, restlessness, nervousness, increased urination, insomnia, flushed face, stomach
upsets, and muscle twitching (National Drug and Alcohol Research Centre [NDARC], 2005).
American culture, combined with caffeine’s wide availability, easy access, placement in
commonly consumed beverages and foods, and its possibility of addiction, allows and
encourages millions of Americans to consume it on a regular basis. On average, an American
adult consumes around 200 mg of caffeine a day (NDARC, 2005 and Mahan & Escott-Stump,
2008, p. 1277) and the average woman takes in over 30 gallons of caffeinated drinks a year
(Somer, 2001). Although caffeine is widely accepted as a common ingredient in American’s
everyday diets, one may want to take caution and explore its possible effects in the diet of
mothers and infants, especially during times of pregnancy and lactation.
Depending on the amount and form of caffeine consumed, health conditions, the size of
ones body, and ones sensitivity to it, caffeine affects individual’s bodies differently and in
varying time frames. Extensive research has shown that throughout pregnancy, women and
infants consuming caffeine may be affected in a variety of ways. The likelihood of getting
pregnant, fetal mortality rates and birth weight can all be affected by maternal caffeine ingestion.
Breastfeeding infants may also be affected by caffeine absorbed into the breast milk.
Studies give contradictory reports on the association between amounts of consumed
caffeine and infertility in women. According to the March of Dimes, consuming small amounts
of caffeine probably won’t reduce women’s chances of becoming pregnant; however, some
studies have found that women who consume more than 300 mg of caffeine a day may have
trouble conceiving (as cited by the Reproductive Toxicology Center, 2007). But upon the close
of a clinical study done on 104 women who were trying to conceive, it was concluded that
women who consumed more than 100 mg of caffeine (200 mg less then the previously sighted
article) were half as likely to get pregnant as those who consumed little to no caffeine in their
diets (Wilcox et al., 2008). However, there are also numerous studies concluding that caffeine
doesn’t actually affect conception, one of which states that caffeine alone won’t affect the
probability of conception (Hakim, Gray, & Zacur, 1998). Given these conflicting reports, if a
woman is trying to conceive and isn’t successful, she may consider cutting back on the amount
of caffeine she regularly consumes.
The effect of caffeine on pregnancy has been thoroughly researched. During pregnancy,
maternal consumption of caffeine, and everything else, reaches the fetus by crossing the
placenta. Maternally ingested caffeine may influence cell development and decrease blood flow
to the placenta, which can harm the baby, however, if the arteries are constricted, the amount of
blood flow may be dramatically limited which can result in miscarriage (Weng, Odouli, & Li,
2008). The half life and elimination time of caffeine in the body both greatly increase compared
to that of a woman who isn’t expecting a baby (Berger, 2008).
Studies completed on caffeine’s affects on the fetus also vary but should all be taken
seriously. One study, found in the American Journal of Obstetrics and Gynecology, concludes
that compared to women who don’t consume caffeine, women who consume it, in amounts equal
to, or in excess of 200 mg a day, are twice as likely to miscarry (Weng et al., 2008). In a
different study found in the American Journal of Epidemiology, over a period of 6 years, from
1996 to 2002, over 80,000 women were questioned about their coffee consumption during
pregnancy. Their pregnancy information and medical records were also reviewed. Of those
women being studied, it was discovered that over 1,000 of them miscarried. Upon the
conclusion of the study, the authors found that the elevated levels of coffee consumption during
pregnancy were linked with a higher risk of fetal death (Bech, Nohr, Vaeth, Henriksen, & Olsen,
2005).
For years experts have wondered if consuming caffeine and low infant birth weight were
related. Several studies have been conducted, but with differing results. Some say that smaller
amounts of caffeine regularly consumed may affect birth weight, while others conclude that
caffeine isn’t a factor in birth weight at all. Recent research conducted regarding the association
of birth weight and caffeine in the maternal diet concludes that unless caffeine is consumed in
amounts greater than 600 mg on a daily basis it probably isn’t linked to a light birth weight
(Bracken, Triche, Belanger, Hellenbrand, & Leaderer, 2002).
Research involving after-birth defects in infants and children whose mothers consumed
caffeine show that the effects aren’t long-term. The Center for Addiction and Mental Health
[CAMH] affirms that newborns of women who consume large amounts of caffeine (more than
500 mg/day) while pregnant may be more likely to have cardiac arrhythmias: faster or irregular
heart rates, tachypnea: faster breathing, and may sleep less than normal in the first days of life
(as cited in Hadeed & Siegel, 1993, p. 45-47). The CAMH also states that there aren’t reports of
exposure to caffeine having lasting or life-long effects on children (CAMH, 2007).
During lactation, consumption of caffeine results in it being excreted into the breast milk.
The amount of actual caffeine released in the milk and that the baby consumes is generally minor
and usually will not show significant effects. However, if an infant becomes fussy, irritable, or
has difficulty sleeping the American Academy of Pediatrics [AAP] Committee on Drugs
recommends moderating or discontinuing caffeine intake (AAP, 2001).
While there aren’t any regulatory or definitive guidelines for caffeine amounts during
pregnancy and lactation, and while effects may vary, it is wise to take these and other sources
and studies into consideration when determining dietary intake. Limiting or discontinuing
caffeine intake during pregnancy and lactation seems to be a wise step in creating a healthy
environment and diet for both mother and child. When in doubt, one should ask their health care
provider for advice.
REFERENCES
American Academy of Pediatrics, Committee on Drugs. Policy Statement: The Transfer of Drugs
and Other Chemicals into Human Milk. Pediatrics, September 2001, volume 108, number
3, pages 776-789.
Bech B.H., Nohr E.A., Vaeth M., Henriksen T.B., Olsen J. (2005) Coffee and fetal death: a
cohort study with prospective data. American Journal of Epidemiology 162:983–990.
Berger A: Effects of caffeine consumption during pregnancy. J Reprod Med 33:945-56, 1988.
Retrieved May 24, 2008, from http://thomsonhc.com
Black, J.D., Gavin, M.L. (2008). Caffeine. Retrieved May 23, 2008, from
http://www.kidshealth.org
Bracken M.B., Triche E.W., Belanger K., Hellenbrand K., Leaderer B.P., (2003) Association of
maternal caffeine consumption with decrements in fetal growth. American Journal of
Epidemiology 157:456-466
Centre for Addiction and Mental Health. (2007). Caffeine. Retrieved May 24, 2008, from
http://www.camh.net
Hadeed, A. & Siegel, S. (1993). Newborn cardiac arrhythmias associated with maternal caffeine
use during pregnancy. Clinical Pediatrics, 32 (1), 45–47.
Hakim R.B., Gray R.H., & Zacur H.: Alcohol and caffeine consumption and decreased fertility.
Fertil Steril 1998; 70:632-637.
Mahan, L.K. & Escott-Stump, S. (2004). Appendix 39: Nutritional Facts on Caffeine-Containing
Products. Krause’s Food, Nutrition, and Diet Therapy (12 ed.). Philadelphia: Saunders.
March of Dimes. (Feb. 2008) Caffeine in pregnancy. Retrieved May 23, 2008, from
http://www.marchofdimes.com
National Drug and Alcohol Research Centre of the University of New South Wales. (2005)
NDARC fact sheet [caffeine]. Retrieved May 23, 2008, from
http://ndarc.med.unsw.edu.au
Pollard I., Murray J.F., Hiller R., Scaramuzzi R.J., Wilson C.A.: Effects of Preconceptual
Caffeine Exposure on Pregnancy and Progeny Viability. J Matern Fetal Med 1999;
8:220-4.
Reproductive Toxicology Center. Caffeine. Updated 8/1/07, accessed by the March of Dimes
1/22/08.
Somer, E. (October, 29, 2001) Jittery about caffeine during pregnancy. Is caffeine okay during
pregnancy?. Retrieved May 23, 2008, from http://www.webmd.com
Stanton C.K. & Gray R.H.: Effects of caffeine consumption on delayed conception. American
Journal of Epidemiology 1995; 142:1322-1329.
Weng, X., et al. Maternal Caffeine Consumption during Pregnancy and the Risk of Miscarriage:
A Prospective Cohort Study. American Journal of Obstetrics and Gynecology, published
online, January 21, 2008.
Wilcox A. et al: Caffeinated beverages and decreased fertility. Lancet 2:1453-6, 1988. Retrieved
May 24, 2008, from http://www.thompsonhc.com
NUTRITION SOURCE RATINGS
Name of reference
Author/
Credentials
Source
Purpose
References
Total
Points
AAP
Bech, B.H. et al.
Berger, A.
Black, J.D. et al.
Bracken, M.B. et al.
CAMH
Hadeed, A. et al.
Hakim, et al.
Mahan, L.K. et al.
March of Dimes
NDARC
Pollard, I. et al.
Reproductive
Toxicology Center
0
2
2
2
2
0
1
2
2
0
0
2
0
2
2
2
1
2
1
2
2
2
1
1
2
2
2
2
2
1
2
1
2
2
2
1
2
2
1
2
2
2
1
2
2
2
2
2
2
0
2
2
6
8
8
5
8
4
7
8
8
4
3
8
5
Somer, E.
Stanton, C.K. et al.
Weng, X. et al.
Wilcox, A. et al.
2
2
2
2
1
2
2
2
1
2
2
2
0
2
2
2
4
8
8
8
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