How much caffeine/alcohol can I consume during pregnancy and breastfeeding?

Caffeine:

Studies have shown that if consumed in excess during pregnancy, caffeine can have adverse effects on the mother and baby. However, moderate amounts of caffeine during pregnancy has not shown to be harmful during pregnancy.

That being said, the current caffeine recommendation during pregnancy is <200 mg of caffeine daily. This equates to about 12oz of coffee.

Reminder:

Caffeine is not only found in coffee, but some sodas, teas, as well as chocolate. Even some headache medications such as Excedrin have notable amounts of caffeine that should be monitored.

Excessive caffeine drinkers:

For those who regularly consume excessive amounts of caffeine in a day while pregnant (>200mg), studies have found that there is a possibility that the excess caffeine can affect the sleep patterns of both mom and baby in the later stages of pregnancy. This is due to the fact that caffeine crosses over into the placenta and effects the baby's energy levels.

Other studies have shown that excessive intake of caffeine can lead to difficulties with conception. In rarer cases, women who drink excessive amounts of caffeine while pregnant have a higher incidence of miscarriages.

While breastfeeding:

While breastfeeding, caffeine consumption is not as much of a concern. Within the first two days of a full-term baby's life, caffeine may accumulate in the baby's body. For this reason, caffeine should be monitored (<200 mg) on these starting days. After these first two days, Mamas do not need to worry about excessive caffeine consumption in regards to the health of their newborn (and breastmilk composition).

A.k.a. Mom's caffeine consumption postpartum (after the first two days) will not effect the baby's sleep or decrease exclusive breastfeeding rates as was once thought.

However, these guidelines are different for premature baby. Caffeine consumption should be monitored (<200 mg) until they are of mature gestational age. If you are unsure of when your baby is of 'mature gestational age' please feel free to contact us and we will help provide the answer.

Alcohol:

According to current studies, there is NO SAFE LEVEL OF ALCOHOL CONSUMPTION during pregnancy. There is such a high level of alcohol restriction during pregnancy due to the high risks of Fetal Alcohol Spectrum Disorders (FASDs).

What are Fetal Alcohol Spectrum Disorders (FASDs)?

This spectrum encompasses a variety of developmental and cognitive issues due to alcohol intake during pregnancy. Alcohol is so dangerous for your baby because it passes through their umbilical cord, through their blood stream, and then directly to their brain.

Fetal Alcohol Spectrum Disorders (FASDs) can lead to lower birth weights, stunted growth, poor attention, poor memory, hyperactivity, learning disabilities, speech and language delays, lower IQ, poor reasoning and judgement, vision and hearing problems, and complications with their kidneys, bones, and heart.

For more information regarding FASDs and intake of alcohol during pregnancy--- check out the CDC's website here or from our references below.

Breastfeeding and alcohol:

While breastfeeding, recommended alcohol consumption levels are significantly less strict. We have all heard the phrase "pump and dump"... however studies are showing that dumping breastmilk after drinking may not be necessary if using precaution.

Because alcohol is water soluble, alcohol leaves the breastmilk the same way it leaves the bloodstream. Therefore 'pumping and dumping' is wasting perfectly safe breastmilk if breastfeeding occurs after the alcohol has left the bloodstream. If a Mom wants to test their breastmilk with alcohol sensitive strips to see the true amount of alcohol in their breastmilk, they may, but it is not necessary.

How much alcohol is safe daily while breastfeeding?

According to the Institute of Medicine, current guidelines state that mothers can consume up to two alcoholic beverages a day while breastfeeding. Specifically 0.5 g of alcohol per kg of maternal body weight per day.

Higher alcohol consumption while breastfeeding has been associated with shorter exclusive breastfeeding rates (meaning they are only ever given breastmilk--no formula). This could be due to mothers becoming less attentive (due to alcohol in their system), changes in lactation hormones, and missed feedings due to lessened recognition of the baby's hunger cues.

Fun fact:

Respecting the above guidelines while breastfeeding, mother's should actually enjoy their alcoholic beverage while breastfeeding so the alcohol does not have time to reach the 'actively let-down breastmilk'. Then, by the time the baby wants to feed again, the alcohol is already out of the Mama's system.

To conclude:

While pregnant, decrease your daily caffeine consumption to <200mg, and restrict ALL alcohol consumption. While breastfeeding, minimize your caffeine consumption the first two days postpartum (for a full-term infant) or if your baby was born premature (minimize caffeine until of mature gestational age)--- after that, you are free to drink your ice coffee in peace! And remember, no need to pump and dump if using precaution. Simply let the alcohol leave your system before breastfeeding!

Thank you for reading and please sign up on our mailing list for Mamas Maternal Health updates and weekly blog posts at www.mamasmaternalhealth.com and join us today!

Until next time!

Mikayla and Cassie

Mamas Maternal Health Registered Dietitians/Lactation Counselors

References:

Caffeine Intake During Pregnancy

https://americanpregnancy.org/pregnancy-health/caffeine-intake-during-pregnancy/

The Lactation Counselor Training Course Notebook (2018)., Healthy Children Project, Center for Breastfeeding., p89

Fetal Alcohol Spectrum Disorders (FASDs) https://www.cdc.gov/ncbddd/fasd/alcohol-use.html

Photo by Hélder Almeida on Unsplash

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