PREGNANCY

Caffeine Rules When Pregnant + Breastfeeding

April 21, 2021

written by: Lo Mansfield, MSN, RN

I’m Lo.
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Sometimes, when we are pregnant, it feels as if all we are subjected to is rules. Rules for how to exercise, how to eat, how to care for our bodies, how to feel, what to put on our skin. For the mama choosing to breastfeed or pump, the rules continue postpartum, as our bodies are working hard to make the milk meant to nourish our littles ones.

I have walked through all of these do’s and don’ts three times myself, so I too understand how annoying the rules can be, how frustrating it might feel to constantly have “right” numbers and values thrown at you. But the nurse side of my brain also appreciates the science behind these numbers, especially evidence-based rules and practices that I do believe are for our good and the good of our little one.

Let’s talk about the prenatal diet for a minute; and in particular, caffeine consumption.

Did you know that there are some considerations and rules about how much caffeine the healthcare community believes is best in both pregnancy and when nursing? We live in a culture largely obsessed with caffeine, in its most common form as coffee. However, we (especially those of us who do not drink coffee) must also remember that caffeine sneaks into our diet in a lot of other ways, many of which can also cause you to quickly hit the suggested daily consumption levels.

CAFFEINE CONSUMPTION RECOMMENDATIONS

In Pregnancy: <200 mg/day

Breastfeeding/Pumping: <200 mg/day

A quick note: The numbers represented here are from the American College of Obstetrics and Gynecology (ACOG). They are one of the larger governing bodies of obstetric care in the United States.

Though the recommendation(s) for caffeine consumption during pregnancy are largely similar, the amount of caffeine that has been deemed appropriate during breastfeeding is not universally agreed upon. While ACOG continues to recommend that women maintain that limit of 200mg when they are postpartum, you will find a multitude of sources that report anywhere from 0-750mg/day.

WHY ISN’T THERE A CLEAR CONSENSUS?

In pregnancy, it IS known that caffeine can cross the placenta and raise maternal catecholamine levels. Because of this, there has been concern in the obstetric community that there may be a a relationship between caffeine exposure and miscarriage. There have been some studies done on this possible relationship. However, ACOG believes that the studies have been too limited by their sizes and bias; at this time, the relationship between caffeine and miscarriage continues to be undetermined and they have not made any changes to their recommendation.

Though ACOG has landed in this place, other professionals and providers may interpret the existing data and/or evidence differently. Because there is not a clear, evidence-based consensus, it is highly possible that you may have a provider comfortable with intake levels higher or lower (or none) than this 200mg recommendation.

In the postpartum period, a clear consensus also does not exist about how much caffeine is appropriate. This is because caffeine does pass to the baby through breastmilk, but different levels affect infants differently. One text related to the topic, Medications and Mother’s Milk (pg. 139), reports that caffeine is Category L2 (safer) as related to risk to infant. The American Academy of Pediatrics classifies caffeine as a “Maternal Medication Usually Compatible with Breastfeeding.”

At this time, most providers will concur that postpartum caffeine consumption is appropriate in moderation (200-300 mg/day), dependent on baby’s health and age. If the amount of caffeine being consumed appears to be negatively affecting baby (irritability, fussy, wakefulness, etc.), the recommendation would likely be to decrease caffeine consumption for a couple of weeks and see if that causes appropriate changes to baby’s behavior.

CAFFEINE IN VARIOUS FOOD/DRINK

*These are estimates pulled from products websites and nutritional information. Actual caffeine content may have some variation.

ProductSizeCaffeine (mg)
Starbucks Pike Place Brewed8 oz155 mg
Starbucks Caffe Americano12 oz75 mg
Starbucks Caffe Latte12 oz75 mg
 
Starbucks Caffe Mocha12 oz95 mg
 
Chai Tea Latte12 oz70 mg
Earl Grey Tea (one bag)12 oz40 mg
Nespresso shot1 pod55-125 mg
Maxwell House grounds1 Tbsp50-100 mg
Folger’s Ground Coffee1 Tbsp60-80 mg
Starbucks hot chocolate16 oz25 mg
Diet Coke20 oz91 mg
Pepsi20 oz63 mg
Coca-Cola16 oz45 mg
5 Hour Energy2 oz200 mg
Rockstar Energy16 oz160 mg
Monster Energy16 oz160 mg
Dark Chocolate (candy)1 oz12 mg
Hershey’s Kisses9 pieces10 mg

So, what do we do with all of this information?

By and large, just pay attention! Caffeine can sneak into our diet in a lot of ways and if your desire is to follow the recommendations of your provider or a specific governing body, then you may be surprised by your current daily totals. Conversely, many women need a certain level of caffeine to function at the capacity their life demands; if this is you, then you may need to find a balance between what you need and want versus what is recommended, an autonomy that is yours as a mother.  

Lack of clarity in some of these maternal spaces can be really challenging. But knowledge and information is always power, as it provides you with the tools to make the best choices for YOU and YOUR pregnancy and baby. So, take this knowledge, these recommendations, and these numbers and use them to healthily make a decision you can feel good about. There’s no greater goal that a mama can have for herself.

xoxo,

Lo

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About the Author

Lo Mansfield MSN, RNC-OB, is a specialty-certified registered nurse in obstetrics, postpartum, and fetal monitoring who is passionate about families understanding their integral role in their own stories. She is the owner of The Labor Mama and creator of the Your Body, Your Birth courses. She is also a mama of three, a University of Washington graduate (Go Dawgs), and is currently an expat in Haarlem, Netherlands. 

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