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Drinking coffee during pregnancy and breastfeeding: is it safe, and if so, how much?

Coffee becomes part of the daily routine of many adults, but what about coffee during pregnancy and breastfeeding? It is common to hear pregnant women expressing how much they miss the daily coffee that they stopped drinking as soon as they found out that they were expecting.

But is it necessary to completely stop drinking coffee during your pregnancy and lactation period?

Let’s see what the current literature recommends regarding caffeine intake by expecting and breastfeeding women.

Remember that caffeine is found on coffee, tea, chocolate, sodas, and energy drinks, among other popular beverages, and so, very accessible daily to the pregnant women. Caffeine will be present on different amounts depending on the drink of choice and on its preparation methods.

One standard cup of coffee (8 oz, 237 mL, brewed) would usually have 135 mg of caffeine (76–106 mg if it is instant coffee or 5 mg if decaf).

The American College of Obstetricians and Gynecologists (ACOG) and the UK’s National Health Service (NHS) recommend not to exceed 200 mg of caffeine per day on what the ACOG calls “moderate caffeine consumption”.

The World Health Organization (WHO) recommends lowering the caffeine intake to those expecting mothers consuming over 300 mg per day.

So we can say that as a general consensus, pregnant women are warned against high (over 200-300 mg/day) consumption of caffeine to avoid complications which could affect their babies.

The relationship between high caffeine consumption and detrimental effects on both mother and child such as growth restriction, reduced birth weight, preterm birth or stillbirth, have not been completely determined and it remains impossible to say with certainty that these pathologies are directly caused by caffeine. However, only with the possibility of a link between high caffeine intake and any adverse effect on a mother or her child should make us all follow the daily limit advice given by these scientific organizations.

Since caffeine is also found on breastmilk, with its levels rapidly elevated after maternal consumption, it is also recommended for breastfeeding mothers to limit its consumption to a maximum 300 to 500 mg daily. However, if the babies are preterm or newborn, due to their slow and immature metabolism, it is recommended for mothers to consume even lower amounts of caffeine (200 mg would be considered within the safe limits).

Again, the current evidence and medical recommendations point to the same: enjoy your coffee in moderation, consuming 1 to 2 cups of coffee a day is not expected to be a concern. And please, should you wish to know more, have this discussion with your obstetrician and neonatologist.


Written by Dr José Francisco Fernández

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