Caffeine and Pregnancy: How Much Is Safe?

Is it safe to drink caffeine when you’re pregnant? Or should you cut it out completely?

Certified nurse midwife Shatoya McQueen, DNP, CNM, shares what you need to know about caffeine during pregnancy and how it can affect fetal development.

How much caffeine can you have while pregnant?

If you’re pregnant, both the American College of Obstetricians and Gynecologists and the American Pregnancy Organization recommend limiting your caffeine intake to 200 milligrams (mg) per day. That total includes caffeine from drinks, foods, supplements and medications with caffeine in them. (More on sneaky sources of caffeine in a bit).

Wondering how much that is?

“One cup of average brewed coffee is about 137 milligrams of caffeine,” says Dr. McQueen. “So, if you have just one cup of brewed coffee a day, you should be within the recommended limit.”

If that’s a big change for you, that’s OK.

“Be sure to let your doctor or midwife know how much caffeine you usually drink or eat so they can help guide you toward the right caffeine intake level,” she adds.

What caffeine does to your body when you’re pregnant

While we know how caffeine affects pregnant women, how it impacts fetal development — and later, your baby’s health — is less certain.

During pregnancy, it can take longer for your body to metabolize caffeine. That means that it hangs out in your bloodstream longer than usual. Providers refer to the time it takes for caffeine to leave your bloodstream as “caffeine clearance.” The slower your caffeine clearance, the longer you’ll feel its effects.

“Caffeine raises your blood pressure and heart rate, which can make you feel more alert and energetic,” Dr. McQueen explains. “But it’s also putting additional stress on your body.”

Being over-caffeinated can cause some unpleasant side effects, like:

• Feeling jittery or anxious
• Heart palpitations
• Nausea and acid reflux
• Dehydration
• Diarrhea
• Shakiness (tremors)
• Muscle twitches

Don’t underestimate the impact these side effects can have. For example, extra coffee may mean peeing more than you already do during pregnancy. That may seem like a small price to pay for an extra boost of energy. But if you pee too much, it can contribute to electrolyte imbalances, dehydration and sleep disruptions.

How caffeine impacts fetal development

The exact impact caffeine has on fetal growth and development remains a subject of ongoing scientific debate.

During pregnancy, your placenta provides the fetus with food and oxygen through the umbilical cord. Because of this, when you drink coffee or other caffeinated beverages, the fetus is exposed to caffeine as well.

Some studies suggest that consuming high amounts of caffeine may increase the risk of miscarriage, low birth weight and other complications. But Dr. McQueen notes that these findings remain inconclusive.

The American College of Obstetricians and Gynecologists agrees. After reviewing the data, it released a statement noting that moderate caffeine consumption does not appear to be a major contributing factor in miscarriage or preterm birth.

“While some studies show conflicting evidence, experts do agree that it’s best to keep your caffeine intake under 200 mg per day,” Dr. McQueen reiterates.

Sources of caffeine to watch for

One reason cutting down your caffeine intake can be tough is that it can appear in many unexpected places, including certain foods and medicines.

If you’re pregnant, you should monitor how many coffees, teas, sodas and energy drinks you consume. You should also watch for these additional sources:

• Chocolate: That bowl of chocolate ice cream or mug of hot chocolate you’ve been craving? Unless it’s artificially flavored, it likely contains caffeine. “The darker the chocolate, the greater the caffeine content,” Dr. McQueen reports.
• Matcha: All green tea has caffeine, but matcha (including matcha-flavored foods) often contains more because the powder is made from the entire tea leaf. The caffeine content can vary based on the type, preparation method and brand.
• Other foods: Kola nuts, guarana and yerba mate are natural sources of caffeine. Be sure to check labels on coffee-flavored snacks, protein bars and even certain types of gum.
• Caffeinated waters: While less common, some flavored water beverages contain added caffeine. Ditto for certain flavor-enhancing drops.
• Supplements: Many types of supplements come with a side order of caffeine. While you probably aren’t using one for weight loss right now, it’s common to add caffeine to pre-workout and protein powders, too. Always check with your provider about any dietary supplements you take, just to be safe.
• Medications: Caffeine is often added to over-the-counter medications for pain, headaches and migraines.

Tips for managing caffeine intake

Dr. McQueen says the following techniques can help you stay within the 200 mg daily caffeine limit more comfortably.

• Don’t quit cold turkey. Suddenly stopping caffeine can lead to withdrawal headaches. Instead, try reducing your intake by one serving a day until you reach your goal.
• Switch to decaf. If you usually drink four cups of coffee per day, consider making the first cup caffeinated and the others decaf. Another option is to make two “half-caff” cups to spread your caffeine intake throughout the day!
• Try other drinks. Not all herbal teas are considered safe to drink during pregnancy, but peppermint and ginger teas are commonly recommended options. Or maybe spring for that sparkling water or seltzer that makes you feel fancy. These refreshing alternatives can help keep you on track!
• Keep it interesting. Add sliced fruit to your water or tea for a little something different.
• Get some extra sleep. Take advantage of your reduced caffeine intake by going to bed slightly earlier than usual. Even 30 extra minutes could help you feel awake and alert the next day.
• Stay active. Instead of meeting a friend for coffee, take a walk together. Light physical activity can boost your energy and mood and get your heart rate up without the unpleasant side effects.

Final thoughts

If you’re unsure how much caffeine is too much or have questions about your diet during pregnancy, talk with your Ob/Gyn or midwife.

General guidelines are great to have, but they’re just that: general. If you have pre-existing medical conditions or are particularly sensitive to caffeine, it’s worth discussing that with your provider. They can help ensure you make the right decisions for you and your baby. 

You should also feel comfortable sharing any concerns about cutting back on caffeine. Your provider won’t judge you. Chances are, they enjoy the caffeine as much as you do.