Caffeine during pregnancy: how much is safe

Up to 200 mg of caffeine a day is considered safe during pregnancy. That is about two mugs of filter coffee, and it is half the 400 mg limit for other adults.

Two bodies give the same figure. The European Food Safety Authority says habitual intake up to 200 mg a day raises no safety concern for the unborn child. The American College of Obstetricians and Gynecologists says that less than 200 mg a day does not appear to be a major contributing factor in miscarriage or preterm birth.

This page describes published guidance. It does not replace advice from your own doctor or midwife, who may set a lower limit for you.

What does 200 mg of caffeine look like?

The limit covers everything with caffeine in it, not only coffee.

A cafe coffee is often stronger than these figures. Most chains use two shots in a medium cup, which makes a latte about 125 mg instead of 62. If you do not know how many shots went in, count it as two.

Why caffeine lasts longer when you are pregnant

Pregnancy slows the speed at which the body clears caffeine. One study measured the half-life at about 3 hours in women who were not pregnant and about 10.5 hours in the last four weeks of pregnancy. The slowing had already begun in the first part of pregnancy.

That has two effects.

Caffeine builds up. A second cup arrives before the first has gone. The same two coffees that cleared by evening before pregnancy can still be active at bedtime.

It costs more sleep. Sleep is already harder in late pregnancy, and caffeine that lingers makes it lighter.

The cutoff times on this site assume an average adult. In pregnancy they are too late, and even the slow setting on the calculator understates the last trimester. As a working rule, keep caffeine to the morning.

Where the caffeine hides

Coffee is easy to count. These are the ones that get missed:

• Tea. A cup of Black tea has 48 mg and Matcha 67 mg.
• Cola. A can of Coca-Cola has 32 mg and Diet Coke 42 mg.
• Energy drinks. A can of Red Bull is 80 mg. A can of Celsius is 199 mg, the whole day's limit. Many energy drinks carry a label advising against use in pregnancy.
• Chocolate. A 50 g bar of dark chocolate has about 40 mg.
• Medicines. Some headache and cold tablets contain caffeine. Check the label, and check with a pharmacist before taking any medicine in pregnancy.

What the guidance does not settle

The 200 mg figure is where the evidence is reassuring. It is not a line with harm on one side and none on the other.

The American College of Obstetricians and Gynecologists notes that the link between caffeine and restricted growth of the baby remains undetermined, and that no final conclusion can be drawn about high intake and miscarriage. Some people choose to go lower than 200 mg for that reason. That is a reasonable choice and one to talk through with your doctor.

How to cut down without the headache

Stopping caffeine at once brings a headache and fatigue for up to nine days, which is the last thing you need in the first trimester.

• Cut in steps. Drop about a quarter of your usual amount each week. The guide to quitting caffeine sets out the steps.
• Swap, do not skip. Replace the afternoon coffee with decaf, which has about 3 mg a mug. You keep the habit and lose the dose.
• Go smaller. A single-shot coffee in place of a double halves the caffeine with no other change.
• Move it earlier. The morning cup matters most to how you feel and least to how you sleep.

Sources

• EFSA Panel on Dietetic Products, Nutrition and Allergies. Scientific Opinion on the safety of caffeine. EFSA Journal, 2015.
• American College of Obstetricians and Gynecologists. Committee Opinion No. 462: Moderate caffeine consumption during pregnancy. Obstetrics and Gynecology, 2010.
• Knutti R, Rothweiler H, Schlatter C. The effect of pregnancy on the pharmacokinetics of caffeine. Archives of Toxicology, Supplement 5, 1982.