Caffeine's Mixed Signals
For the pregnant woman who loves her tea, coffee, or chocolate, these mixed signals can be even more distressing. At the moment the best impartial advice takes all these caffeine conclusions with a grain of moderation. The March of Dimes, while acknowledging that no one really knows whether caffeine, even in moderate amounts, is detrimental to pregnancy or not, suggests a safe level of caffeine to be no more than 300 milligrams a day or less, or about two cups of coffee.
"The research is still mixed," says Sara Cowlan, a nutritionist who practices in New York City. "If you can give up caffeine that's probably the best choice, but I've worked with a lot of women who have great difficulty in giving it up. I tell them that there's a lot of evidence that caffeine is OK in small amounts. Not everyone can give up everything."
Finding Hidden Caffeine
Caffeine is present in other drinks besides the obvious coffee, soda, and tea. It also can be found in supplements and in some foods you might not think of as being a source of caffeine.
The woman who wants to watch her caffeine levels but still needs her two cups of coffee to keep her going in the morning or her glass of tea at lunch needs to be a little more vigilant about avoiding caffeine from other sources. Cowlan, who specializes in counseling pregnant women, says the best way to do so is to read labels. And don't just look for the word "caffeine" on that label. Some drinks and supplements may be marketed as "all natural" or "caffeine free" but can contain the additive guarana, which has the same stimulating effects as caffeine and should be avoided during pregnancy.
Also, never assume something doesn't have caffeine just because it isn't a known source. Caffeine can be found in some products that are traditionally considered caffeine free. For example, orange soda is generally caffeine free, but one popular brand contains 42 milligrams—more than some dark colas. Have that with your two cups of coffee (approximately 280 milligrams) and 1 ounce of chocolate (approximately 10 milligrams) and you're well over your limit. So be sure to read all labels. Here are a couple of other surprises:
- Ice Cream: Caffeine is a given in actual coffee, but one serving of many coffee-flavored ice creams and frozen yogurts can contain more caffeine than a soda. Make sure to look for caffeine in the ingredients list.
- Water: Not plain old water, but any water that is flavored or labeled "vitamin" water may contain caffeine. Some brands give you a blast of caffeine equal to or greater than a cup of coffee. In addition, these drinks often contain other additives and supplements that are not known to be safe for consumption during pregnancy.
- Energy Drinks: If you're low on energy, try a nap instead of one of these. They contain a high concentration of caffeine as well as supplements not considered safe for pregnant women. Guarana is often found in the ingredients for these products along with caffeine—a double whammy.
- Pain Relievers: Some medicines used for headache relief contain rather large amounts of caffeine. Switch to ibuprofen or acetaminophen for a caffeine-free alternative. Of course, no supplement or medication, regardless of its ingredients, should be taken without your doctor's approval.
Tips for Cutting Caffeine
Even if you can't or won't quit altogether, there are strategies to reduce the amount of caffeine in your diet to keep it under the 200-milligrams-per-day target. One suggestion Cowlan makes is to switch to white chocolate. It's still rich tasting but has no caffeine.
Here are some other suggestions for lowering or replacing caffeine in the diet courtesy of Marlene Clark, a registered dietitian at Cedars-Sinai Medical Center in Los Angeles:
- Switch to caffeine-free sodas or coffees. However, do avoid empty calories from these products if weight gain is an issue.
- Instead of buying flavored waters, squeeze a little lemon or lime in water, and make your own.
- Make a half-caf beverage by mixing half regular coffee and half decaffeinated coffee.
- Add more milk to coffee. Warm it in the microwave to keep it from cooling your coffee down too much. In a coffeehouse, order latte with nonfat milk instead of a regular cup of coffee.
- Switch from soda to juice.
- Cut down on the amount of time you steep your tea bag to weaken it a bit.
If you do decide to give up caffeine altogether, do so gradually by eliminating one serving per day. This will help ease the inevitable withdrawal symptoms and make it easier to quit.