In Part 1, I wrote about tea consumption during pregnancy. In part 2, I'm going to tackle a question I get ALL the time. Is caffeine okay during pregnancy?? Do I have to give up my espresso, cold brew or bulletproof coffee?
How much caffeine is too much in pregnancy? Well, the truth is, like many substances, we don't really know. In the scientific world, randomized controlled trials (RCT) are the 'gold standard' of evidenced based medicine. In order, to be able to obtain answers and know a substance is safe, researchers need to conduct studies (RCT) on pregnant women and their developing fetus. As you can imagine, studies on pregnant women aren't very ethical, and as a result, the list of proven 'safe' substances isn't very long. That being said, here's what we do know about caffeine.
Numerous animal (not people) studies have shown that high doses of caffeine may cause birth defects, premature labor, reduced fertility, and increase the risk of having low-birth weight offspring. Yikes, sounds scary.... So, is it better to play it safe when it comes to caffeine and avoid it all together?
Well, perhaps not…. In 2008, two prominent studies on the effects of caffeine related to miscarriage showed significantly different outcomes. One study released in the American Journal of Obstetrics and Gynecology, found that women who consumed 200mg of caffeine daily, were twice as likely to have a miscarriage as those women who didn’t consume any caffeine during their pregnancy. This study was countered by another publication in the Journal of Epidemiology, which found there to be no increased risk for miscarriage in women who drank a minimal amount of coffee daily (between 200-350mg per day.)
From a purely biological perspective, we know that caffeine crosses the placenta and can cause an increase in blood pressure and heart rate in both the mom and baby. Caffeine is a vasodilator and may cause constriction of the vessels that feed the baby nutrients (thus the theoretical risk of low birth weight babies). Caffeine is processed in adults via a complicated metabolic process in the brain and liver. We know that adults can process caffeine but aren't really sure how developing fetal structures metabolize any amount of the tasty stimulant (thus the possibility for fetal neurological issues).
Caffeine’s half-life is extended significantly when pregnant from 2-4.5 hrs in a non-pregnant female, to almost 15 hrs during the third trimester. Anecdotally, I’ve found that pregnant women in my practice report having a stronger response to caffeine, feeling more jittery and ‘wired’ than they did before they were pregnant. Many women just don't crave their morning brew any more. I'd like to think that the body’s wisdom tells us that perhaps a little bit is okay, but too much isn’t safe for cavemom and paleo baby.
Due to conflicting conclusions from numerous studies, the March of Dimes states that until more conclusive studies are done, pregnant women should limit caffeine intake to less than 200 mg/day and Health Canada recommends no more than 300mg/day. This could equal a morning Americano, an afternoon square of dark chocolate and a cup of green tea.
Looking for coffee alternatives?
Try Organic Swiss Water Process decaf or check out Red Espresso, this antioxidant powerhouse is made from Robios tea and brews up in your espresso maker. Paleo peeps are best to stay away from Dandilion blends as they often contain Rye, barley and other grains. Teeccino makes a herbal 'coffee' substitute that is made without barley that is available in the USA but sadly, not in Canada.
Want to stick with your coffee?
No prob! Perhaps switching to 'half caf' .
Bulletproof coffee (if enjoyed in moderation) is certainly 'Meg the Midwife' Approved....with it's high MCT/Butterfat content and low toxic load, it makes a smart choice for the pregnant paleo cavemom and offers benefits to her growing baby.
How much caffeine is in that stuff?
1 oz dark chocolate 20mg
Kombucha GT’s (8oz) 8-14mg
Green tea 20- 50mg
Black Tea 20-90mg
The lighter the roast, the higher the caffeine content.
Espresso, Single Shot - 29-100 mg (often around 75 mg)
French press (8oz) ~ 120-200mg (depends on grind & length of steep)
Decaf Coffee (8 oz) - 2-12 mg
Another little tidbit to part on:
Going for your Glucose Tolerance test? It’s best to skip the morning brew. A 2011 Study published in the Journal of American Perinatology showed that caffeine consumption impaired your glucose tolerance and increased your insulin resistance. This could mean a false positive result on your sugar test and the possibility for a false diagnosis of gestational diabetes. Nobody wants that!