Caffeine in Pregnancy and Lactation

Terri Smith

Nutr 2220

Prof. Lynne Dawson You wake up in the morning to that blaring sound of the alarm clock. You slowly reach over to pound the life out of the clock, then lay back stretching and yawning. The baby inside you has sensed you're awake and is moving all over the place. You stagger your way to the kitchen for a cup of morning coffee with a bowl of cereal. But suddenly it dawns on you, how much caffeine should you be drinking if any? How much is actually safe? Caffeine has been consumed by the human race since the stone age and became famous in tea from back in 300 BCE by the Chinese. For many years it has been controversial in the pregnancy debate. Caffeine is a bitter white crystalline that is part of the psychoactive stimulant group. It can be found in beans, leaves and even in some fruits where is used as a natural pesticide that kills certain insects that feed off the plants. The type of caffeine that humans usually ingest is from the beans of coffee and from the leaves of the tea bush. Caffeine found in energy drinks is from other sources. (Please reference tables in back of report for caffeine levels). Be aware though, it can also be found in over-the-counter drugs such as some headache, cold, and allergy medicines . The FDA does require that the labels of medications list the amount of caffeine that they contain. Pregnant women should always check with their provider before consuming any medication. Some herbal products that contain guarana, yerba mate, kola nut and green tea extract also have caffeine. The FDA does not regulate herbal products and therefore they do not have to say how much they contain. A recent government study showed that some of these products contained anywhere from one cup to eight cups of coffee. Herbal teas very rarely contain caffeine. In the human body, caffeine is a stimulant of the Central Nervous System. It temporarily wards off drowsiness and can make a person feel more alert. It increases heart rate and also acts as a diuretic, more so in those that have no tolerance to caffeine. Many pregnant women have increased heartburn while pregnant, due to pressure the growing fetus applies to the stomach. Drinking caffeine will only increase this even more. Although there is not an agreed upon UL of caffeine, there are signs of over usage. These signs may include restlessness, fidgetiness, nervousness, excitement, euphoria, insomnia, flushing of the face, increased urination, irregular heart beat, mania, depression, disorientation, disinhibition, delusions, hallucinations, and psychosis. The half life of caffeine in healthy adults is approximately 4.9 hours. In a pregnant woman, this half life increases to approximately 9 to 11 hours. According to the March of Dimes, pregnant women should limit their caffeine intake to less than 200 mg per day (approximately one 12 ounce cup of coffee). This limit is based on a study that was carried out and published in the American Journal of Obstetrics and Gynecology in March of 2008 showing a link between 200 mg or more of caffeine a day and a doubled risk of miscarriage. Studies have been conducted since, and there is not a conclusive answer that caffeine and miscarriage are related, but many stay cautious on the topic due to it being inconclusive. Another study was held in Denmark in 2003 found the risk of stillbirth more than doubled in mothers that drank eight cups or more of coffee per day. Some studies have also suggested that caffeine effects birth weight in newborns. Another intriguing study suggested that drinking three cups or more of coffee per day increased the risk of having a son with undescended testes. Moderate amounts of caffeine in studies have shown no effects on a woman's chance of getting pregnant. At the end of all these studies though, there are many to contradict them. Put simply, there