Coffee During Pregnancy: How Much Caffeine Is Safe?

Are you pregnant and wondering whether you should quit your daily coffee habit?

If the prospect of starting each day without a hot cup of joe seems impossible to you, the good news is that most physicians agree coffee is perfectly safe to consume while pregnant. However, there are some qualifiers.

We’ll discuss the effects caffeine can have on both you and your baby and whether decaf is an acceptable substitute.

Once you have all the information, you can make the best decision about whether you want to drink coffee throughout your pregnancy.

Can I Have Caffeine While Pregnant?

The short answer to this question is yes. It is generally considered safe for pregnant women to have up to 200 milligrams of caffeine per day, approximately the amount in one cup of caffeinated, brewed coffee ⁽¹⁾.

The “catch” is that research on this topic is limited and, in some cases, contradictory. This makes it impossible to say that caffeine is unequivocally safe since there seems to be some evidence to the contrary.

And since double-blind studies on pregnant women are not ethical to conduct, research is limited to evaluating women’s self-report after childbirth.

Based on these studies, there is some evidence that too much caffeine may be associated with miscarriage or birth defects, but most studies agree that moderate caffeine poses no health risk to the mother or baby.

If you want to be conservative with your caffeine intake, opt for decaf coffee or skip it altogether. But if you need a daily jolt to get you through the day, you can comfortably opt for one caffeinated cup per day.

Different types of coffee have different levels of caffeine, so be sure you are reading labels or asking how much caffeine is in your daily cup of coffee. When I was pregnant, I couldn’t bear the thought of giving up my morning coffee before the start of my ER shift. My drink of choice was a grande Americano from Starbucks, which luckily consisted of 200 milligrams of caffeine. Boy, was I glad that caffeine level was exactly the amount allotted to me!

Editor's Note:

Mary Sweeney, BSN, RN, CEN

How Much Caffeine Is in Coffee?

While the recommended amount of caffeine is one cup or 200 milligrams of caffeine, the actual amount of caffeine in your coffee will vary based on the type of java you choose. Here’s a rundown on the types of coffee beverages you may come across and the amount of caffeine in each of them:

1. Brewed

This is the most popular type of coffee made at home. Brewing coffee involves making coffee by running water through the grounds. This can be done through a drip coffee system, percolator, pour-over brewer, or French press.

The caffeine content varies based on the specific coffee and the brewing method ⁽²⁾. Light roasts have a higher caffeine content than dark roasts as the caffeine is not burned off during the roasting process.

Coffee that is brewed using a method that keeps it in contact with the water longer, like percolating, has more caffeine than other methods.

2. Espresso

Espresso is a shot of coffee brewed quickly with high temperatures and high pressure. Espresso shots are one ounce in volume and are enjoyed alone in smaller amounts. They can be consumed on their own or combined with other ingredients in a specialty espresso beverage.

Some of the most popular espresso beverages are:

• Latte: Espresso with milk.
• Americano: Espresso diluted with water.
• Cappuccino: Espresso with steamed milk and foam.
• Mocha: Espresso with milk and chocolate syrup.

Most espresso beverages come with more than one shot, so that’s important to keep in mind when ordering your beverage. It’s also important to remember that chocolate contains caffeine, too!

3. Cold Brew

Cold brew coffee is a newer trend that involves steeping grounds directly in cold water over 24 hours, then filtering out the grounds. It results in a stronger but smoother and less bitter coffee.

While it tends to have more caffeine, thanks to the extended brew time, cold brew coffee is generally more concentrated and therefore is consumed in a diluted form.

So while a full eight-ounce cup of cold brew may have higher levels of caffeine than regular coffee, you’ll likely consume fewer than eight ounces in a typical cup since it will probably be diluted with milk, creamer, syrup, or water.

4. Instant Coffee

Instant coffee comes in powdered form. Granules are mixed with hot water to make a near-instant cup of coffee. Often they are flavored or contain creamer along with the coffee mix.

How is Decaffeinated Coffee Made?

One way to enjoy your morning coffee without the caffeine is to switch to decaffeinated coffee. There are four main ways that caffeine is extracted from coffee beans:

• Indirect solvent: In this method, coffee beans are soaked for a period of time, which extracts the caffeine, flavor, and other nutrients. The beans are then mixed with a solvent that bonds with the caffeine. When the beans are heated, both the solvent and caffeine evaporate.
• Direct solvent: Coffee beans are steamed to open the pores, then rinsed with a chemical solvent that bonds with the caffeine and helps remove it.
• Swiss water process: This process is entirely chemical-free but not widely used. Coffee beans are soaked to extract caffeine molecules, then run through a charcoal filter to strain out the larger caffeine molecules. This water is then used to soak a new batch of coffee beans, but because it is already flavor-rich, it only extracts the caffeine from the beans and leaves the flavor. Decaf coffee produced using this method is always labeled “Swiss Water Decaf.”
• Carbon dioxide method: This method is used for large-batch decaffeination. The carbon dioxide dissolves and extracts the caffeine without chemicals and without removing the flavor from the coffee beans.

While the solvent methods are deemed safe by the FDA, some individuals are wary about exposure to chemical residue as a result of these decaffeination methods. If it concerns you, research how caffeine is extracted from your favorite coffee brands before purchasing them.

Keep in mind also that decaf coffee is never entirely caffeine-free. It is only required to be 97 percent decaffeinated, leaving about five milligrams of caffeine per cup. That can add up quickly if you drink several cups throughout the day.

How Does Caffeine Affect a Fetus?

Caffeine crosses the placenta, so it easily enters your baby’s bloodstream. It affects their body in similar ways to yours, but because their liver is immature, they cannot metabolize it at the same rate as you can.

This means the caffeine may be more concentrated in your baby’s bloodstream and may remain there longer. Caffeine increases your baby’s heart rate and respiration and can also block the absorption of nutrients like calcium. This can result in your baby having weaker bones at birth.

Excessive caffeine consumption during pregnancy has also been linked to an increased risk of Sudden Infant Death Syndrome, or SIDS.

How Does Caffeine Affect My Body?

Caffeine affects your body in many ways — some good and some bad. Some positive effects of caffeine use are:

• Increased concentration.
• Increased energy.
• Increased productivity.

However, there are plenty of adverse effects on your body, too. These are a few of the negative effects:

• Increased blood pressure: Caffeine constricts your blood vessels and raises your blood pressure. This can be particularly dangerous during pregnancy, especially if you’re at risk for a blood-pressure-related condition such as preeclampsia.
• Increased heart rate: Because caffeine in coffee is a stimulant, it increases your heart rate and respiration.
• Increased urination: Caffeinated coffee is a diuretic, meaning it causes more water to be expelled from your body through the process of urination. If you’re pregnant, you probably already spend plenty of time in the bathroom. Drinking coffee will not only increase trips to the bathroom, but it may cause you to cut back on drinking other more hydrating fluids to combat the increased need to urinate. This can result in dehydration, which is not healthy at any time but can be particularly dangerous during pregnancy.
• Decreased absorption of nutrients: Caffeine has been shown to restrict your body’s ability to absorb essential nutrients such as calcium and iron. During a time when you’re more likely than ever to watch your nutrition for the sake of your baby, you may want to re-think the amount of caffeine you consume if it’s negating some of your health efforts.
• Restricted blood flow to the placenta: Since caffeine constricts your blood vessels, it can also restrict blood flow to your uterus and placenta.
• Increased risk of miscarriage: Studies have shown that women who consume excessive amounts of caffeine during the first trimester have twice the risk of miscarrying compared to those who don’t. However, it’s also important to note that studies evaluating moderate caffeine intake — anywhere between 150-300 milligrams — didn’t find any notable negative effects on pregnancy or miscarriage risks.
• Poor sleep: Every woman metabolizes caffeine at a different rate. However, if the stimulating effects are still coursing through your veins at bedtime, it can deteriorate your already-broken pregnancy sleep. It’s usually a good idea to avoid caffeine after noon to prevent it from affecting your sleep.

When you’re pregnant, your metabolism slows, and your body may have a harder time eliminating toxins. This means the caffeine you consume may stay in your body longer at higher levels, compounding the effects of caffeine you experience.

Can Caffeine Withdrawals Hurt My Baby?

Quitting caffeine can have unpleasant effects, but they aren’t dangerous. These are some of the common caffeine withdrawal symptoms ⁽³⁾:

• Headaches.
• Fatigue.
• Difficulty concentrating.
• Depressed mood.
• Irritability.
• Anxiety.
• Brain fog.

The worst symptoms usually subside within the first 48 hours after quitting caffeine, but other bothersome symptoms may stick around for up to a week ⁽⁴⁾.

If you quit caffeine while pregnant, the withdrawal process will not harm your baby. If you consume large amounts of caffeine throughout your pregnancy, your baby may be born addicted and suffer withdrawal symptoms after birth.

Again, these aren’t harmful — just unpleasant.

If you’d like to cut down on your caffeine while minimizing the withdrawal symptoms, don’t go cold-turkey. Instead, gradually reduce the amount of coffee you drink, the number of cups per day, or switch to half-caf.

What Should I Be Aware of When Drinking Coffee While Pregnant?

Before you turn on that coffee pot as you stagger out of bed in the morning, here are a few more things you should consider for a complete picture.

1. Morning Sickness

If you struggle with morning sickness or pregnancy nausea, coffee is probably one of the worst beverage choices you could make. It’s highly likely you’ll lose your taste for it as it’s one of the most common food aversions for pregnant women.

It also won’t coat your stomach the way other foods will, so it won’t help with nausea resulting from an empty belly.

2. Type of Coffee

Different types of coffee can have varying levels of caffeine, so be sure to check the amount before consuming it. And if you’re ordering an espresso beverage from your favorite barista, ask how many shots they include in your beverage so you can calculate your caffeine intake accurately.

If you’re not ready to skip your double tall morning latte, ask for half-caf. They’ll sub one of the espresso shots for decaf, and you probably won’t even notice the difference.

3. Total Caffeine Consumption

Coffee is not the only beverage that contains caffeine! If you regularly enjoy other drinks like tea, soda, energy drinks, kombucha, or hot chocolate, you need to keep track of the total amount of caffeine you’re consuming. This will ensure you stay below the recommended 200-milligram threshold.

4. Time of Day

Before opting for coffee, consider the time of day. The general recommendation is to avoid coffee afternoon to keep it from affecting your sleep. However, your tolerance may differ, and you may be able to enjoy coffee later in the day without noticing a difference.

Even after being pregnant, I choose a cup of decaf coffee every night. It satisfies my need for something hot after dinner without keeping me awake all night!

Editor's Note:

Mary Sweeney, BSN, RN, CEN

5. Point in Pregnancy

While the research isn’t definitive, some evidence suggests there’s a relationship between caffeine consumption and miscarriage. If you are concerned about miscarriage, try to limit caffeine as much as possible during the first trimester of your pregnancy, when your miscarriage risk is the highest.

FAQs

How Do I Know if Coffee is Affecting My Baby?

If your morning cup of joe is affecting your baby, they probably won’t text you about it. In general, moderate caffeine consumption (under 200 mg per day) is considered safe during pregnancy.

But if you notice unusual activity like increased or decreased movements or if you’re just worried, it’s best to discuss it with your healthcare provider. They’re the real coffee gurus in this case.

Can Coffee Cause Spina Bifida?

No, coffee is not the villain in the Spina Bifida story. The most significant risk factors for spina bifida are genetic and nutritional, particularly a lack of folic acid during early pregnancy. So don’t let your coffee take the blame for this one.

Does Coffee Affect Brain Development?

Extensive research is still ongoing, but so far, there isn’t conclusive evidence that moderate caffeine consumption (less than 200 mg per day) negatively affects a baby’s brain development.

But, like any good mystery, there may be undiscovered clues. If you’re unsure, it’s best to consult with your healthcare provider.

What Can I Drink Instead of Coffee When Pregnant?

So you’ve given coffee the boot, but now you’re feeling adrift in your morning routine. You can try alternatives like decaf coffee, herbal tea, or hot lemon water.

Even a smoothie could give you that much-needed kickstart. Remember, it’s not about replacing coffee; it’s about finding a healthy new ritual that suits you and your baby.

The Bottom Line

There is no one-size-fits-all answer when it comes to coffee and caffeine consumption while pregnant.

While it hasn’t been scientifically proven to be 100 percent safe, the general medical consensus is that 200 milligrams per day of caffeine is a safe amount, which is roughly equivalent to one cup of caffeinated coffee.

Only you and your doctor can make the best decision for you about your coffee consumption during pregnancy. Try to avoid drinking a lot of coffee, but you shouldn’t feel guilty about enjoying your morning java or the occasional afternoon pick-me-up.