Mums-to-be need more guidance on the risk of caffeine during pregnancy

New Tommy’s research shows that we need to do more to raise awareness of the risks of caffeine during pregnancy.

Drinking a lot of caffeine in pregnancy has long been linked to pregnancy complications, such as miscarriage, low birth weight and stillbirth. But new research from the Tommy’s Maternal and Fetal Health Research Centre shows that although most (54%) of women cut down on caffeine during their pregnancy, 1 in 20 women actually increased their caffeine intake during pregnancy. This is worrying and shows we need to do more to raise awareness of the risk of caffeine during pregnancy.

What did the research show?

The Tommy’s research clinic team studied more than 1,000 mums across 41 UK hospitals between 2014 and 2016. They combined information typically used to measure stillbirth risk with a questionnaire about caffeine consumption. The questionnaire included various caffeinated drinks to see whether links could be made between stillbirth and certain levels of caffeine consumption. 

Although most (54.5%) people cut down on caffeine while pregnant, 1 in 20 actually increased their intake. This shows that there is more work to do to raise awareness of the risks of caffeine during pregnancy. 

Energy drinks had the most impact, leading to a 1.85 times higher stillbirth risk. This was followed by instant coffee (1.34x) and cola (1.23x). However, it wasn’t possible to separate the impact of caffeine from that of sugar in cola and chemicals like taurine in energy drinks. We need to investigate this further in order to better understand specifically where the risk is coming from.

This new study also reports that the more caffeine consumed per day, the higher the risk of stillbirth. This is why it is a good idea to reduce the amount of caffeine you have as much as possible during pregnancy. 

Why is caffeine harmful during pregnancy? 

Caffeine, like many substances found in a normal diet, can be harmful in large amounts. Babies can’t process caffeine like adults, so when large amounts cross through into the placenta, it can be dangerous. Even though a little bit can be okay, staying on the safe side can help mums to have a healthier pregnancy. The official guidance is to keep caffeine consumption low while pregnant. 

Swapping to decaffeinated tea and coffee, fruit juice or water are all good choices if you are used to drinking a lot of caffeinated drinks.

I’ve been drinking lots of caffeine – what do I do?

Try not to worry too much if you’ve gone over the suggested limit before. Caffeine is one part of pregnancy health, alongside eating a balanced diet, keeping physically active, going to antenatal care appointments and seeking help for unusual symptoms. 

It’s not always clear when something has caffeine in or how much it contains, and even if people are trying to cut down, milligrams don’t mean a lot to most of us so it can be hard to keep track. You can calculate how much caffeine you are consuming by using our caffeine calculator.

Charlotte Stirling-Reed, registered nutritionist and mum to three-year-old Raffy and four-month-old Ada, says:

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Caffeine intake can be really confusing. Even as someone with a background in nutrition, it can be hard to work out the amounts in different drinks and how much is consumed each day. Often many people just aren’t aware of how much caffeine there is in some of their favourite foods and drinks. All mums want the best for their baby, during pregnancy and beyond, and so anything that can be done to help break down the guidance and give practical tips on why and how to cut down is really important. We don’t want to make anyone more worried during pregnancy, so it’s really key to get credible and supportive messages out, and Tommy’s is doing wonderful work at offering practical tools without scaremongering.

— Charlotte Stirling-Reed

Will the NHS guidance on caffeine change?

Current NHS guidance is to keep daily caffeine intake below 200mg during pregnancy. This new study reports that the more caffeine consumed per day, the higher the risk of stillbirth. This suggest that limits that are considered ‘completely safe’ in these guidelines should be reconsidered. Official guidelines get reviewed and updated regularly as new evidence becomes available. In the meantime, our advice is just to cut down as much as possible rather than worrying about specific numbers. Look out for ‘hidden caffeine’ in things like fizzy drinks and making healthy swaps to decaf options.

What does this mean for me and my pregnancy?

The message from the researchers is that parents shouldn’t be unduly concerned. Overall, caffeine only poses a small risk, but improving your health and making your pregnancy as safe as possible means being aware of all the risks. 

Professor Alexander Heazell, Tommy's research centre director and professor of obstetrics at the University of Manchester, said:

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“Anyone planning to have a baby needs to know that consuming caffeine during pregnancy can raise the risk of stillbirth and other pregnancy complications, so it’s important to cut down as much as you can; the national guidelines should be the limit, not the goal, and the more you can cut down beyond that the better. Breaking habits can be hard, but little things like switching to decaf and swapping fizzy drinks for fruit juice or squash can really help reduce the risk.”

— Professor Alexander Heazell

We have lots of information and advice that can help you keep an eye on your caffeine intake, and making simple changes can have an immediate positive impact, so there are plenty of things you can do to take control of your caffeine consumption if you’re worried. Check out www.tommys.org/your-pregnancy-1-2-3 for advice on pregnancy health, and you can specifically check your caffeine intake at www.tommys.org/caffeine-calculator
 

I had caffeine in a previous pregnancy – is this why my baby was stillborn? 

Please remember that loss is very rarely caused by anything you did or did not do. NHS advice is still to keep caffeine intake below 200mg a day, and you shouldn’t feel guilty for following the evidence and guidance. In many cases when a baby is stillborn, no cause can be found which can cause some parents to blame themselves. But try to remember that it’s not your fault. We’re working to find answers through our research into the causes of stillbirth.