Can You Drink Coffee During Pregnancy? Caffeine Limit and Alternatives

You can drink coffee in pregnancy, but in limited amounts. The NHS and the European Food Safety Authority (EFSA) recommend that caffeine from all sources should not exceed 200 milligrams a day in pregnancy. Depending on the type of coffee and the size of the cup, this often means one or two cups of coffee a day; tea, cola and chocolate taken the same day count towards this too.

You do not have to give up coffee completely; what matters is knowing your total caffeine through the day. Below you will find the approximate caffeine content of common drinks, how the limit can be passed without noticing, and alternatives you can try without giving up your enjoyment.

How Much Caffeine Is Safe a Day in Pregnancy?

The recommended upper limit in pregnancy is 200 mg of caffeine a day. EFSA states that this amount, spread through the day, does not raise a safety concern for the baby; the NHS recommends the same limit.

Caffeine crosses the placenta and is cleared from the body more slowly in pregnancy. The NHS reminds us that too much caffeine has been linked with a higher risk of miscarriage and stillbirth. The American College of Obstetricians and Gynecologists (ACOG) states that moderate consumption of under 200 mg a day does not appear to be a major factor in miscarriage or preterm birth. In short, the issue is not coffee itself but the amount.

How Much Caffeine Is in Which Drink?

The amount of caffeine varies with the type of coffee, the brewing time and the size of the cup. The values below are approximate figures published by EFSA and the NHS.

Decaffeinated coffee also contains a very small amount of caffeine, but its effect on the daily total is usually negligible. Large-size drinks sold in coffee shops and coffees with a double shot of espresso can come close to 150–200 mg on their own; that is why the choice of size matters.

Can You Drink Turkish Coffee and Tea in Pregnancy?

Yes, as long as you stay within the total caffeine limit. The caffeine in Turkish coffee varies with the amount of coffee used and the size of the cup; a small cup of Turkish coffee generally contains less caffeine than a large mug of filter coffee, though it is hard to give an exact figure.

Tea, on the other hand, is the drink most often overlooked in the caffeine count in Turkish households. Strong teas drunk one after another through the day can take you over the 200 mg limit even if you drink no coffee at all. Brewing tea lightly, cutting the number of glasses and replacing some with herbal tea or hot water are practical solutions.

How is the limit passed in a day?

• A large-size filter coffee in the morning (about 150 mg) + two strong teas in the afternoon (about 150 mg) = about 300 mg
• One espresso-based coffee (about 80 mg) + a can of cola (40 mg) + two teas (about 100 mg) = about 220 mg
• A cup of Turkish coffee + two light teas + a few squares of dark chocolate = often under the limit

These examples are to show how the limit can be passed without noticing the total. Noting what you drink through the day for a few days is the easiest way to see your own habits.

Do Coffee and Tea Affect Iron Absorption?

Yes. Some compounds in tea and coffee can reduce the absorption of iron, especially from plant sources. The NHS also advises cutting back on tea and coffee in iron deficiency anaemia.

Because iron needs rise in pregnancy, it is a good habit to drink tea and coffee not with meals but at least an hour before or after them. If your doctor has recommended an iron supplement, do not take it with tea or coffee either. For advice on anaemia in pregnancy, you can look at the article on iron deficiency and anaemia in pregnancy, and for details on iron-rich foods the article on vitamin and mineral needs during pregnancy.

What Are the Caffeine-Free Alternatives?

There are many ways to cut caffeine while keeping your coffee or tea ritual. The aim is to keep the warmth of the drink and the pleasure of the break while lowering the caffeine load.

• Decaffeinated coffee: The easiest switch for those who miss the taste of coffee; making the second coffee of the day decaffeinated is a good start.
• Half and half: You can halve the caffeine by mixing regular and decaffeinated coffee.
• Hot milk or milk-based drinks: They also provide calcium and protein; have them without added sugar or with only a little.
• Water with fruit or lemon, plain mineral water, ayran (Turkish salted yoghurt drink): They meet your fluid needs and contain no caffeine.
• Herbal teas: The NHS recommends limiting herbal teas in pregnancy to four cups a day and avoiding teas that contain liquorice root. Ask your doctor which herb suits you; for details you can look at the article on herbal teas in pregnancy.

Cutting caffeine gradually

If you are used to drinking several cups of coffee a day, stopping caffeine suddenly can cause temporary complaints such as headache, tiredness and restlessness. It is easier to cut back a few days at a time instead:

1. In the first week, swap the last caffeinated drink of the day for a caffeine-free option.
2. Make your coffee cup smaller; choose a small instead of a large size, and a single shot instead of a double.
3. Brew tea lightly and reduce the number of glasses through the day one at a time.
4. Combine your coffee break with a walk, a glass of water and a small snack; often what you are after is not the caffeine but the break.

Tiredness is very common in pregnancy and is the most frequent reason for reaching for coffee. Regular meals, enough water, iron-rich foods and, as far as possible, regular sleep support your energy more evenly through the day. If the tiredness is marked, or comes with shortness of breath or palpitations, tell your doctor; iron deficiency, which is common in pregnancy, can cause similar complaints.

Energy drinks are not recommended in pregnancy, because they can contain not only caffeine but other stimulants and a lot of sugar.

Does Caffeine Affect Pregnancy Complaints?

In some expectant mothers, caffeine can make heartburn, palpitations and sleep problems worse. Because of its diuretic effect, it can also make the need to go to the toilet more frequently more noticeable.

If you have heartburn, not drinking coffee on an empty stomach and cutting the amount may help; you can find more advice on this in the article on what helps heartburn in pregnancy. For sleep quality, having your last caffeinated drink in the early afternoon also helps. If the smell of coffee bothers you in the early weeks because of nausea, you can treat this as a natural opportunity to cut down caffeine; the article on nutrition in the first 3 months of pregnancy has practical suggestions for this period.

Can You Drink Coffee While Breastfeeding?

Moderate coffee consumption is generally not a problem while breastfeeding either; but some of the caffeine passes into breast milk and some babies may be more sensitive to it. If you notice restlessness or sleep problems in your baby, try cutting your caffeine and talk to your paediatrician about it.

If you would like a personal plan for drink choices, fluid needs and your daily eating routine in pregnancy, we can work together, in line with your obstetrician's advice, within nutrition counselling for pregnancy. If you are curious about the general effects of caffeine, you can also look at the article on coffee and caffeine; the page on nutrition while breastfeeding is a good starting point for the breastfeeding period.

Sources

• NHS – Foods to avoid in pregnancy
• EFSA – Caffeine
• ACOG – Moderate Caffeine Consumption During Pregnancy
• NHS – Iron deficiency anaemia

This article is for general information only; please consult your doctor and dietitian about your own situation.