Alternatives to Coffee During Pregnancy

Every year, over 200 million women in the world ask themselves the same question: “What can I drink now that I’m pregnant?” Let’s explore the possible options for expectant mothers and also identify unsuspected sources of caffeine in beverages.

Risks associated with coffee consumption during pregnancy

During pregnancy, the health of both the mother and the fetus is of primary importance. Concerning caffeine intake during this phase and during breastfeeding, various studies have highlighted potential risks associated with its consumption. Caffeine can cross the placenta and reach the fetus, and excessive amounts of this substance may be linked to an increased risk of miscarriage and premature birth [1]. Moreover, some studies suggest that high caffeine intake could be associated with an increased risk of fetal developmental delays and low birth weight [2]. Current guidelines recommend limiting caffeine intake during pregnancy to approximately 200-300 mg per day [3].

If you want to know more about drinking coffee during pregnancy, read: The Impact of Caffeine Consumption on Pregnancy and Breastfeeding

World Health Organization’s Recommendations

The World Health Organization (WHO) provides clear guidelines regarding caffeine consumption during pregnancy, recognizing its presence in various sources such as tea, coffee, non-alcoholic beverages, chocolate, and some over-the-counter medications. In particular, coffee stands out as one of the most common sources of high caffeine intake. The WHO’s intervention, updated on August 9, 2023, emphasizes the significant slowdown in caffeine clearance from the mother’s bloodstream during pregnancy [4]. In pharmacology, clearance indicates the organs’ ability to eliminate a drug from the body, specifically referring to the volume of plasma (or blood) that the kidneys can purify of a substance in a given time unit, degrading it to urea, which is then eliminated through urine. During pregnancy, the mother’s ability to clear caffeine decreases, potentially leading to associations between excessive caffeine consumption and adverse outcomes, such as decreased fetal growth, reduced birth weight, premature birth, or fetal death.

In light of these results, the WHO specifically addresses pregnant women with a high daily caffeine consumption, i.e., exceeding 300 mg. The organization recommends reducing daily caffeine intake during pregnancy. Therefore, adhering to these WHO guidelines represents a preventive measure for expectant mothers against adverse pregnancy outcomes associated with excessive caffeine consumption.

The information mentioned above is available in the document “WHO recommendations on antenatal care for a positive pregnancy experience.” This document provides comprehensive guidelines on prenatal care, including specific recommendations for caffeine consumption during pregnancy. You can consult the official WHO document on “WHO recommendations on antenatal care for a positive pregnancy experience” here.

European Food Safety Authority Guidelines

The Scientific Opinion on the safety of caffeine from the European Food Safety Authority (EFSA) provides a thorough assessment of caffeine consumption safety. Following a request from the European Commission, the EFSA’s expert group on Dietary Products, Nutrition, and Allergies was tasked with providing a scientific opinion on the subject, offering advice on caffeine amounts from all food sources that do not raise concerns for the general health of the population and its subgroups.

According to the EFSA’s scientific opinion, habitual caffeine consumption up to 200 mg per day in pregnant women and up to 200 mg per day in breastfeeding women poses no safety concerns for the fetus or newborn.

The Italian Ministry of Health relies on these EFSA indications to formulate guidelines on the safety of caffeine consumption in the population [5].

Main Alternatives to Coffee During Pregnancy

The possible alternatives to coffee during pregnancy are numerous; we’ll list just a few, such as Rooibos, Green Tea, and Decaffeinated Tea.

Rooibos, originating from South Africa, stands out for its caffeine-free nature and richness in antioxidants. Its well-known anti-inflammatory and relaxing properties can provide a flavourful experience without the associated risks of caffeine [6]. Scientific studies suggest Rooibos might even have health benefits, contributing to blood pressure control and immune system improvement [7].

Green Tea is renowned for its antioxidant properties and potential heart health benefits. With a lower caffeine content than coffee, it can be a balanced choice for pregnant women. However, it’s essential to monitor overall caffeine intake, considering other potential sources from the daily diet [6].

Decaffeinated Tea remains a popular choice for those who want to enjoy the warmth and comfort of a teacup without the stimulating effects of caffeine. The decaffeination process significantly reduces caffeine content, making this beverage a safe option for pregnant women. Choosing reliable brands is crucial to ensure proper decaffeination [6].

Beverages Not Considered Coffee Alternatives

Now, let’s delve into the unsuspected ones – beverages that may seem innocuous but are not considered entirely safe. Here are some examples:

Not all drinks commonly associated with coffee alternatives are recommended during pregnancy. Some infusions, such as Hibiscus, Nettle Tea, and Black Tea, may pose risks and should be avoided in certain circumstances.

Hibiscus, known for its vibrant color and tangy taste, carries the risk of lowering blood pressure and interacting with certain medications. During pregnancy, where blood pressure monitoring is crucial, consuming this beverage should be limited or avoided [8].

Nettle Tea, often linked to health benefits, may have a potential uterine-stimulating effect during pregnancy, leading to contractions. Some experts advise against nettle tea consumption during the first trimester to reduce the risk of uterine contractions. The American Pregnancy Association considers it “likely unsafe,” although the Natural Medicines Database rates nettle as probably unsafe. This discrepancy might relate to which part of the nettle plant is used – the root or the leaves – and how much is consumed. Some sources encourage nettle use during pregnancy for its health benefits.

Black Tea, while containing less caffeine than coffee, still holds a significant amount. Excessive caffeine consumption is associated with pregnancy risks, so carefully monitoring total caffeine intake is essential [9].

In conclusion, it is crucial to be aware of beverages that, despite their popularity, might not be safe during pregnancy. Consulting with a healthcare professional to assess the suitability of such drinks based on individual conditions is always recommended. According to the American Pregnancy Association, these are some ingredients you might find in herbal teas, with some having a doubtful safety rating. Safety ratings provided here come from the Natural Medicines Database.

 

Tea and Herbal Infusions: The Main Differences

Herbal infusions often provide an additional source of nutrients such as calcium, magnesium, and iron. However, due to the lack of studies on many herbs, the Food and Drug Administration (FDA), a United States government agency tasked with protecting and promoting public health through the regulation and supervision of food products, recommends caution when consuming herbal infusions.

There are true teas and herbal teas, or more accurately, herbal infusions.

True teas are derived from the tea plant’s leaves and come in only three types: black, green, and oolong. They all contain caffeine but in varying percentages, along with different quantities of antioxidants.

The greater the leaf’s oxidation (fermentation), the higher the caffeine level. Infusion time, leaf size, and leaf type can also influence the tea’s caffeine content. Decaffeinated teas still contain some caffeine.

 

Herbal Infusions during Pregnancy: Considerations and Conclusions

Herbal infusions are made from the roots, berries, flowers, seeds, and leaves of plants other than the tea plant. Herbal infusions do not contain caffeine. These infusions can also be used as medicinal remedies, either related to or possessing medicinal properties.

Since herbal infusions are naturally caffeine-free, they do not pose specific concerns from this perspective. However, as mentioned earlier, not all herbal infusions are harmless during pregnancy.

Concerns about consuming herbal infusions during pregnancy stem from the lack of available data on various herbs and their effects on a developing fetus. There are conflicting opinions on the safety of herbal infusions, both for pregnant and non-pregnant women.

Most commercially produced brands of herbal infusions are considered safe for anyone consuming them in reasonable quantities. Herbal infusions deemed unsafe include those not made commercially, those made with excessive amounts of herbs (quantities exceeding those found in common foods or beverages), and those made with herbs known to be toxic.

In conclusion, exploring alternatives to coffee during pregnancy requires a balanced approach in light of available scientific evidence. The discussed alternatives, such as Rooibos, Green Tea, and Decaffeinated Tea, are supported by research emphasizing their safety during pregnancy.

However, it is crucial to note that some beverages commonly perceived as alternatives, such as Hibiscus, Nettle Tea, and Black Tea, may present risks and require increased caution.

The recommendations of the World Health Organization and the Ministry of Health provide a general framework. The health of both the mother and the child should always remain at the forefront of dietary choices. Awareness and understanding of the specifics of each beverage can contribute to a more peaceful and risk-free pregnancy.

 

References

  1. Chen LW, Wu Y, Neelakantan N, Chong MF, Pan A, van Dam RM. Maternal caffeine intake during pregnancy and risk of pregnancy loss: a categorical and dose-response meta-analysis of prospective studies. Public Health Nutr. 2016 May;19(7):1233-44. doi: 10.1017/S1368980015002463. Epub 2015 Sep 2. PMID: 26329421; PMCID: PMC10271029. https://pubmed.ncbi.nlm.nih.gov/26329421/
  2. CARE Study Group. Maternal caffeine intake during pregnancy and risk of fetal growth restriction: a large prospective observational study. BMJ. 2008 Nov 3;337:a2332. doi: 10.1136/bmj.a2332. Erratum in: BMJ. 2010;340. doi: 10.1136/bmj.c2331. PMID: 18981029; PMCID: PMC2577203. https://pubmed.ncbi.nlm.nih.gov/18981029/
  3. American College of Obstetricians and Gynecologists. (2020). ACOG Committee Opinion No. 462: Moderate caffeine consumption during pregnancy. Obstet Gynecol. 2010 Aug;116(2 Pt 1):467-468. doi: 10.1097/AOG.0b013e3181eeb2a1. PMID: 20664420. https://pubmed.ncbi.nlm.nih.gov/20664420/
  4. WHO recommendations on antenatal care for a positive pregnancy experience: https://www.who.int/publications/i/item/9789241549912
  5. EFSA NDA Panel (EFSA Panel on Dietetic Products, Nutrition and Allergies), 2015. Scientific Opinion on the safety of caffeine. EFSA Journal 2015; 13(5):4102, 120 pp. doi: 2903/j.efsa.2015.4102 ; https://www.efsa.europa.eu/en/efsajournal/pub/4102
  6. Von Gadow, E. Joubert, C.F. Hansmann, Comparison of the antioxidant activity of rooibos tea (Aspalathus linearis) with green, oolong and black tea, Food Chemistry, Volume 60, Issue 1, 1997, Pages 73-77, ISSN 0308-8146, https://doi.org/10.1016/S0308-8146(96)00312-3. (https://www.sciencedirect.com/science/article/pii/S0308814696003123)
  7. Afrifa D, Engelbrecht L, Eijnde BO, Terblanche E. The health benefits of rooibos tea in humans (aspalathus linearis)-a scoping review. J Public Health Afr. 2023 Dec 1;14(12):2784. doi: 10.4081/jphia.2023.2784. PMID: 38204815; PMCID: PMC10774856.; https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10774856/
  8. Diane L. McKay, C-Y. Oliver Chen, Edward Saltzman, Jeffrey B. Blumberg,Hibiscus Sabdariffa L. Tea (Tisane) Lowers Blood Pressure in Prehypertensive and Mildly Hypertensive Adults,The Journal of Nutrition,Volume 140, Issue 2, 2010, Pages 298-303, ISSN 0022-3166, https://doi.org/10.3945/jn.109.115097; https://www.sciencedirect.com/science/article/pii/S0022316622069632;
  9. “Caffeine content for coffee, tea, soda and more,” https://www.mayoclinic.org/healthy-lifestyle/nutrition-and-healthy-eating/expert-answers/caffeine/faq-20058459

Disclaimer

The information contained herein is not and is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Before making any changes to your diet, exercise or treatment, always consult your doctor or a qualified health professional.

The guidance provided may not be appropriate for your specific situation. Never make any decisions about your health based solely on the information provided in this article.

The author and creator of this article are not responsible for any damage or loss resulting from the improper use of the information presented here. Remember that each person is unique and therefore needs a personalized approach to health.

If you have any concerns about your health, please consult a qualified medical professional.