Caffeine in pregnancy

Caffeine is a drug found in things like coffee, tea, soda, chocolate and some energy drinks and medicines. It’s a stimulant, which means it can keep you awake.

How does caffeine affect you and your baby during pregnancy?

Caffeine slightly increases your blood pressure and heart rate and the amount of urine your body makes. Caffeine may cause you to feel jittery, have indigestion or have trouble sleeping. During pregnancy, you may be especially sensitive to caffeine because it may take you longer to clear it from your body than if you weren’t pregnant. It may also make you feel nauseous or lightheaded. 

When you have caffeine during pregnancy, it passes through the placenta to your baby. The placenta grows in your uterus (womb) and supplies the baby with food and oxygen through the umbilical cord.

You may have heard that too much caffeine can cause miscarriage (when a baby dies in the womb before 20 weeks of pregnancy), preterm birth (birth that happens before 37 weeks of pregnancy is completed) or low birth weight (when your baby is born weighing less than 5 pounds, 8 ounces). Some studies say this is true, and others don’t.  

Until we know more about how caffeine can affect pregnancy, it’s best to limit the amount you get to 200 milligrams each day. This is about the amount in 1½ 8-ounce cups of coffee or one 12-ounce cup of coffee. Be sure to check the size of your cup to know how much caffeine you’re getting.

What foods and drinks contain caffeine?

Caffeine is found in:

• Coffee and coffee-flavored products, like yogurt and ice cream
• Tea
• Some soft drinks
• Energy drinks
• Chocolate and chocolate products, like chocolate syrup and hot cocoa
• Some medicines

The amount of caffeine in foods and drinks varies a lot. 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, even though you think of them as a cup. 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.

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.  

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.

The list below shows the amount of caffeine in common food and drinks. The caffeine amounts are averages, so they may change depending on the brand or how the food or drink is made. Check the package label on food and drinks to know how much caffeine they contain.

What medicines contain caffeine?

Some medicines used for pain relief, migraine headaches, colds and to help keep you awake contain caffeine. The Food and Drug Administration (also called FDA) requires that labels on medicine list the amount of caffeine in the medicine.

If you’re pregnant, talk to your health care provider before taking any medicine that contains caffeine. This includes prescription and over-the-counter medicine.  A prescription is an order for medicine given by a health care provider. You can buy over-the-counter medicine, like pain relievers and cold medicine, without a prescription.

Some herbal products contain caffeine. These include guarana, yerba mate, kola nut and green tea extract. Herbal products are made from herbs, which are plants that are used in cooking and for medicine. The FDA does not require that herbal products have a label saying how much caffeine they contain. If you’re pregnant, don’t use herbal products because we don’t know how much caffeine they contain.

Is caffeine safe during breastfeeding?

The American Academy of Pediatrics (AAP) says it’s safe for breastfeeding moms to have caffeine. A small amount of caffeine does get into breast milk, so limit caffeine if you’re breastfeeding. Breastfed babies of women who drink more than 2 to 3 cups of coffee a day may become fussy or have trouble sleeping. You may want to drink less caffeine if your baby was born preterm or newborn because she may digest caffeine more slowly.

Last reviewed: April 2020