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Dr Sears on Caffeine and Pregnancy

Q: I'm pregnant, and while I know that caffeine isn't good for my baby-to-be, I have a slight addiction to the caffeinated sodas I drink daily. I've tried to stop drinking caffeinated beverages entirely, but then I experience migraines if I don't intake some caffeine. Exactly how bad is caffeine for my unborn child? Should I just quit caffeine cold turkey, and deal with the migraines?

A: New insights into the possible harmful effects of caffeine on a developing fetus have led obstetricians to increasingly discourage caffeine consumption during pregnancy. Some studies have shown that the offspring of pregnant animals given caffeine displayed a higher incidence of malformations. Excessive caffeine consumption (defined as drinking three or more cups of coffee or tea daily during the first trimester) has been also associated with a higher incidence of miscarriage and low birth weight. Plus, as it does in adults, caffeine can increase a baby's heart rate. Also, because a fetus' immature liver can't rid itself of the caffeine as quickly as an adult liver, the caffeine may remain in the fetus' bloodstream longer, and at higher levels. A further caution is that caffeine has similar metabolic effects as the stress hormone adrenaline; both can theoretically reduce blood flow to the uterus.

Besides being harmful for your developing baby, caffeine—at least in high doses—could be harmful to you. Research suggests that pregnant women detoxify caffeine at a slower rate while pregnant, allowing the caffeine to build up to higher levels in the bloodstream and remain in the system longer, compounding its effects. Caffeine also has a diuretic effect, which can increase the frequency of urination (increasing your already—frequent nighttime trips to the bathroom) and can possibly lead to dehydration. Also, it can lessen the absorption of iron from foods in your diet during pregnancy.

It sounds like you're not so much "addicted" to caffeine, as you are using it as a "medicine" to relieve the headaches. It's natural to want to stick with your daily soda intake if that's what works for you. However, for your health and that of your baby, consider trying the following alternatives.

Lessen the dose

Since headaches are a common symptom of caffeine withdrawal, and you already suffer from migraines, very gradually lessen the amount of caffeine you drink. Some migraine suffers find that even a small amount of caffeine can be enough to relieve their headaches. Gradually wean yourself off of coffee, tea, and other caffeine-containing drinks by sipping smaller amounts throughout the day. Drinking smaller amounts more frequently may lessen the sudden addictive jolt of high levels of caffeine in your bloodstream. Also, consume your beverage slowly—sip a soda over an hour or so, rather than downing it all at once.

Decaffeinate or lessen the caffeine in what you brew

Here's a trick I use to decaffeinate tea: Dip the bag in very hot water for 20 seconds. Discard that liquid and put the tea bag into a fresh cup. Since caffeine is very soluble in water, just 20 to 30 seconds will remove much of the caffeine while preserving most of the flavor. Or, try switching to sipping on herbal teas and decaffeinated coffee or tea. Usually these still contain a tiny bit of caffeine; possibly just enough to keep you from suffering headaches. Also, shorten brewing times. The longer tea and coffee are brewed, the more caffeine is likely to be released.

Try healthier substitutes

If you're also in the habit of drinking tea and coffee as well as soda, you're probably conditioned to the soothing effects of the warm water and/or the flavor. Try herbal teas or even just hot water with a few drops of lemon juice. As far as your soda habit is concerned, your best bet is to completely eliminate all caffeine-containing sweetened beverages from your diet while pregnant. The combination of the caffeine buzz and the sugar rush is an absolute no-no for the body at all times, and especially when you're pregnant. In addition, almost all sodas contain phosphoric acid which can leach calcium from your bones—and that's a vital bone-building nutrient both you and your baby need this during this time.

The next time you see your healthcare provider, ask about alternative ways to treat and prevent migraines so that you can enjoy a healthy pregnancy and healthy baby.