Is it safe to drink coffee during pregnancy?

Short answer: Moderate your consumption of coffee. Not more than 1 or at most 2 cups of Indian coffee with milk per day assuming no tea, colas, chocolate etc., The lesser the better.

Coffee contains the ingredient caffeine. Caffeine can increase your blood pressure because of its stimulative properties and makes you more alert. Increased wakefulness and higher blood pressure are not helpful during a pregnancy. Caffeine also crosses the placenta easily and reaches the baby. Since baby's metabolism is still developing, the baby cannot fully metabolize the caffeine¹.

Some studies have shown that excess caffeine  may increase the likelihood of infertility, birth defects, miscarriage, stillbirth, premature birth, fetal growth restriction, and SIDS. . But there is no conclusive research on this. There were numerous other factors that may have caused this, besides caffeine¹.

The general medical advice for pregnant Indian women is to moderate consumption of caffeine containing beverages like coffee, tea, colas that contain caffeine etc.  Caffeine is found not only in coffee but also in tea, chocolate, soft drinks like coke etc.

Currently, there is not much conclusive research done on how much caffeine is OK for pregnant Indian women. The United Kingdom's Food Standards Agency advises that pregnant women not consume more than 300 mg/day²of caffeine. The US FDA (the United States Food and Drug Administration) advises pregnant women to avoid coffee or use it sparingly during pregnancy and keep your intake below 200 mg/day, lesser than the UK limit. Different countries have different limits.

According to the Indian Coffee Board, regular coffee (roast and ground arabica beans) typically has 120 - 150mg of caffeine in each glass (8 oz, ~250ml)³.

Based on a 300 mg/day limit, the consumption of average regular Indian coffee with milk can be 1-2 cups per day for pregnant women. However, the less consumed the better. Based on a 200 mg/day limit, pregnant Indian women should take only 1 cup of Indian coffee with milk every day.

The caffeine in coffee depends on the following:

• Kind of coffee - Robusta beans have more caffeine than Arabica beans
• Filter coffee has more caffeine than instant coffee
• Preparation of coffee - black coffee has a lot more caffeine than coffee with milk
• Brand of coffee. 

Here is the amount of caffeine found in some everyday items (source: International Food Information Council)⁴

• Some soft drinks - Typically 24 mg with a range of 20 to 40 mg per 250ml
• Energy drinks - Typically 80 mg
• Milk chocolate - Typically 6 mg with a range of 1 - 15 mg per 30 grams
• Dark chocolate - Typically 20 mg, with a range of 6 - 35 mg per 30 grams
• Chocolate syrup - Typically 4 mg per 30ml

It is easy to keep adding caffeine in your system as you eat and drink all these caffeine-rich items. Be careful and reduce your intake of these items as well along with coffee.

Replace coffee with…

• Tea has little less than half the caffeine than coffee so if you really need that caffeine kick, it is better to have tea over coffee.
• You can also reduce the caffeine in your coffee by adding more milk than before (added calcium and protein as well for you and your baby)
• Green tea
• Lots of hot water

But if you really need to have coffee on a regular basis, discuss with your doctor and try and cut back caffeine in other forms like soft drinks, chocolate etc.

References

1. Edmund Hey, "Coffee and pregnancy" BMJ 2007;334:377

2. "When you're pregnant", UK Food Standards Agency

3. India Coffee Board "Coffee-Part of a healthy, balanced diet", Coffee & Health, October 2006

4. Reprinted from the International Food Information Council Foundation and Association of Women’s Health, Obstetric, and Neonatal Nurses, August 2002