Can I continue drinking 1-2 cups of coffee during pregnancy? How about when trying to get pregnant?
There is still much to learn about what impact caffeine and coffee have on fertility and pregnancy. Until we know more, the recommendation is to limit your coffee input to less than 12 oz of coffee, or less than 1-2 cups of coffee in pregnancy or no more than 200 mg of caffeine a day, though at least one study showed that even less was associated with some risks of smaller babies.
How much caffeine is in a cup of coffee?
In general, 8 oz. of coffee contains about 100 mg of caffeine, but it also depends on the kind of coffee and the brew. Many people however often don’t know that sometimes one cup is more than one cup and may contain more than 300 mg of caffeine. For example, Starbucks coffees are named:
- Short [8 fl. oz.]
- Tall [12 fl. oz.]
- Grande [16 fl. oz.]
So a "Grande" is actually 2 cups of coffee and contains over 200 mg of caffeine depending on the brew. A tiny espresso is less than 1-2 oz but contains about 75mg of caffeine, nearly as much as an 8 oz cup of coffee, and 3 espressos have over 220mg caffeine.
The main ingredient of concern in pregnancy of coffee is caffeine which is also an ingredient in many different drinks such as colas, cocoa, and chocolate.
A study published in January 2015 concluded that consumption of caffeine and coffee increases the risk of pregnancy loss, and the more you drink the more likely the loss. In another study, caffeine intake over 300 mg was associated with increased early pregnancy loss. In this study, the risk of pregnancy loss rose by 19% for every increase in caffeine intake of 150 mg/day and by 8% for every increase in coffee intake of two cups per day.
Some studies have linked certain pregnancy complications such as miscarriage, low birth weight, and birth defects such as cleft palate to large amounts of caffeine. That's about what you'd get in two to three cups of coffee or about seven cans of cola. But there may be some cups of coffee that could contain up to 550 mg of caffeine. Read here for a list of beverages and the amount of caffeine they contain. Even though less than 300 mg of caffeine has not been shown to negatively affect pregnancy, many women limit or cut out caffeine anyway while trying to get pregnant and during pregnancy.
Another study from 2018 showed an increased risk of a certain kind of leukemia in the child when the mother drank more than 2 cups of coffee a day.
How does caffeine affect fertility and pregnancy?
Excessive caffeine may have a negative effect on your fertility and pregnancy. During pregnancy, it is important to cut down on your daily coffee intake.
The word "caffeine" comes from the French term for coffee, café. Caffeine is found in varying quantities in the beans, leaves, and fruit of over 60 plants, where it acts as a natural pesticide that paralyzes and kills certain insects feeding on the plants. Caffeine is most commonly consumed by humans in infusions extracted from the beans of the coffee plant and the leaves of the tea bush, as well as from various foods and drinks containing products derived from the kola nut or from cacao.
The effects of caffeine
In humans, caffeine is a central nervous system (CNS) stimulant, having the effect of temporarily warding off drowsiness and restoring alertness. Beverages containing caffeine, such as coffee, tea, soft drinks, and energy drinks enjoy great popularity; caffeine is the world's most widely consumed psychoactive substance, but unlike most other psychoactive substances, it is legal and unregulated in nearly all jurisdictions.
The Food Standards Agency has recommended that pregnant women should limit their caffeine intake to less than 300 mg of caffeine a day - the equivalent of four cups of coffee a day. A higher intake may be associated with miscarriage. A study published in January 2008 concludes that an intake of 200 milligrams or more per day, representing two or more cups, "significantly increases the risk of miscarriage."
What foods and drinks contain caffeine?
Caffeine can be found in the following:
- Coffee-flavored products, like yogurt and ice cream
- Some soft drinks
- Energy drinks
- Chocolate and chocolate products, like chocolate syrup and hot cocoa
The amount of caffeine varies a lot
The exact amount of caffeine in each of these foods and drinks can vary a lot. For example, for coffee and tea, the amount of caffeine depends on:
- The brand
- How it’s prepared
- The type of beans or leaves used
- The way it’s served (for example, as espresso or latte)
- The size of the cup. Not all coffee cups are the same size. Check to see how many ounces your cup has, especially if you’re buying a cup of coffee or tea. If you’re making coffee or tea at home, measure to check the size of the cup.
Energy drinks and caffeine
Some energy drinks contain large amounts of caffeine. For example, a 24-ounce energy drink may have up to 500 milligrams of caffeine. Energy drinks may have a lot of sugar, too, and they may contain ingredients that may be harmful to your baby during pregnancy. Because we don’t know a lot about all the ingredients in energy drinks, it’s best not to have them when you’re pregnant.
Caffeine all adds up
The amount of caffeine you get from food and drinks throughout the day adds up. So if you have a cup of coffee in the morning, you may want to limit or give up having other food and drinks during the day that have caffeine.
Caffeine and fertility
The effect of caffeine on pregnancy is one of the most researched subjects. Several studies in humans have associated increased caffeine use of more than 300 mg of caffeine (or about 2-3 cups) a day with a decrease in fertility and an increase in the incidence of miscarriage or low birth weight babies.
How much coffee is too much in pregnancy?
A regular cup of coffee which is defined as having 8 ounces contains about 100 mg of caffeine. But it may surprise you to find out that “a cup” is not always “a cup,” and that when you drink what you think is a cup of coffee, it may actually contain much more than that.
In preparation for writing this column, I went to our kitchen and took out several cups that are used in our household for drinking coffee. I filled the cups to about 1 inch below the top and measured the content of the fluid in each cup. To my surprise, an average cup actually contains 12 ounces or 1 ½ cups of fluid, and the larger ones contained 16 ounces. Therefore, a tall single cup of “Grande” coffee, for example, contains more than the recommended maximum of 300 mg a day. In addition, when coffee is brewed in different ways if may contain different amounts of caffeine.
Many women are unsure if they should forego their morning cup of coffee or skip their daily coffee break during pregnancy. The confusion regarding this topic is understandable as the recommendations on caffeine and coffee consumption during pregnancy are not as black and white as a cup of coffee with a side of cream!
Most doctors recommend that pregnant women and women considering pregnancy should reduce or eliminate coffee and caffeine from their diets. If you are concerned, your best bet is to try and eliminate caffeine use entirely while trying to conceive or during pregnancy. But if you really need your daily “fix,” 1-2 regular cups of coffee are OK as long as you measure your cups of coffee correctly and you don’t have more than 300 mg caffeine per day.
Does coffee increase my risk of having a miscarriage in pregnancy?
Caffeine may increase your risk of having a miscarriage, especially if you have over 2 cups of coffee a day. A study published in January 2008 concludes that an intake of 200 milligrams or more per day, representing two or more cups, "significantly increases the risk of miscarriage." Currently, available evidence suggests that it may be prudent for pregnant women to limit coffee consumption to 2 cups/day (no more than 200 mg/day of caffeine) to exclude any increased probability of spontaneous abortion or impaired fetal growth.
Another recent study also found a link between coffee intake during pregnancy and miscarriage. It appears that the more coffee you drink during the early stages of pregnancy, the higher your risk of suffering from a miscarriage becomes.
Danish researchers from the University of Aarhus polled over 88,000 women to find out about coffee intake during pregnancy. The majority of these women consumed no coffee during pregnancy, however, those that did report increased risks of miscarriage. Women who consume more than eight cups of coffee a day appear to be at the highest risk, illustrating a 59% increase in the rate of miscarriage. Researchers are still unsure why coffee appears to affect the risk of miscarriage.
How about the effect of caffeine on his fertility?
The effect of coffee on his fertility is not so clear. In this large systemic review, the authors conclude that "... the literature suggests that caffeine intake, possibly through sperm DNA damage, may negatively affect male reproductive function." They suggest that more research is needed to better assess the impact of caffeine on his fertility.
Effects of caffeine
Because caffeine crosses the placenta, large amounts could affect babies in the same way it does adults. These effects include a faster heart rate, tremors, increased breathing rate, and trouble sleeping, but this is only when the mother consumes more than 500mg of caffeine each day (the amount found in more than three cups of coffee).
If you have a cup of coffee in the morning, try not to let it replace other hydrating beverages such as milk, orange juice, or water. This is important because caffeine is also a diuretic, which means it helps eliminate fluids from the body and can result in water and calcium loss. If you drink coffee, keep in mind that you should still strive to include the recommended daily 8-12 eight-ounce servings of water in your diet to stay adequately hydrated.
The benefits of good hydration are many, including detoxifying your body of waste products and aiding in healthy liver and kidney function for both mom and baby. A pregnant woman also needs more water as her body expands during pregnancy and blood volume significantly increases. Not drinking enough water may contribute to fatigue as well as constipation.
Fill your most of your glasses with low calorie and low caffeine products, but don’t let the caffeine content of your morning cup of Joe stop you from enjoying this popular beverage. Coffee is actually a good source of health-promoting antioxidants and has been shown to improve cognitive function and reduce the risk of some diseases. As it goes for almost everything we eat or drink (except for the foods that should be avoided during pregnancy such as alcohol and high-mercury fish), moderation is key. So based on the research, during pregnancy, you can still wake up and smell (and drink) the coffee!