This sheet is about exposure to caffeine in pregnancy and while breastfeeding. This information is based on published research studies. It should not take the place of medical care and advice from your healthcare provider.

What is caffeine?

Caffeine is a stimulant found in many foods and beverages. It is also found in some prescription and over the counter medications. Caffeine is naturally found in the leaves, seeds, and fruits of more than 60 plants. Caffeine’s main effect is making people feel more awake for a short time. Caffeine is also a diuretic, meaning that it helps get rid of fluids from the body. It is important that women who use caffeine stay well-hydrated by drinking enough water. Most experts suggest that women who are pregnant limit their caffeine intake to 200 mg or less per day.

How much caffeine is in common foods and drinks?

The best way to know how much caffeine is in a product is to check the ingredient label. The amount of caffeine in some common items is listed below (amounts are approximate and might vary between products):

• 8 oz. cup of brewed coffee          137 mg
• 12 oz. (tall) Starbucks® cup of coffee 235 mg
• 8 oz. cup of instant coffee          76 mg
• 8 oz. cup of brewed tea            48 mg
• 8 oz. cup of hot chocolate          5 mg
• 12 oz. Coke®               46 mg
• Red Bull® energy drink          67 mg
• 1 cup of coffee ice cream          4 mg
• Milk chocolate bar            10 mg
• Dark chocolate bar            30 mg
• 2 tablets of Excedrin®          130 mg

Some herbal supplements such as guarana also contain caffeine (about 47mg per 1g). Beverages made from the guarana seed also contain caffeine.

I consume (eat/drink) products with caffeine. Can it make it harder for me to get pregnant?

Some studies have suggested that high levels of caffeine (more than 300 mg per day) might make it harder to get pregnant, but these findings are not proven. Low (less than 200mg per day) to moderate (about 200-300 mg per day) caffeine consumption has not been proven to make it harder to get pregnant.

Does caffeine increase the chance of miscarriage?

Miscarriage is common and can occur in any pregnancy for many different reasons. Researchers have not reported an association between low (under 200 mg) levels of caffeine and an increased chance of miscarriage. Some studies suggest that the chance of miscarriage might be increased when people consume moderate (200-300 mg) or high (more than 300 mg) levels of caffeine. As there can be many causes of miscarriage, it is hard to know if an exposure or other factors are the cause of a miscarriage.

Does caffeine increase the chance of birth defects?

Birth defects can happen in any pregnancy for different reasons. Out of all babies born each year, about 3 out of 100 (3%) will have a birth defect. We look at research studies to try to understand if an exposure, like caffeine, might increase the chance of birth defects in a pregnancy. Caffeine has not been shown to increase the chance of birth defects.

Does consuming products with caffeine in pregnancy increase the chance of other pregnancy-related problems?

Most studies find no clear evidence that low (less than 200 mg) to moderate (200-300 mg) of caffeine use during pregnancy can increase the chance of other pregnancy-related problems, such as preterm delivery (birth before week 37) or low birth weight (weighing less than 5 pounds, 8 ounces [2500 grams] at birth). High doses (more than 300 mg) of caffeine are not well studied.

I need to take caffeine throughout my entire pregnancy. Will it cause withdrawal symptoms in my baby after birth?

The use of caffeine during pregnancy can cause temporary symptoms in newborns soon after birth. These symptoms are sometimes referred to as withdrawal. Large amounts of caffeine could affect babies in the same way as it does adults. Some reports suggest that children exposed to more than 500 mg of caffeine per day in the third trimester of pregnancy were more likely to have faster heart rates, shaking, increased breathing rate, and spend more time awake in the days following birth. Not all babies exposed to caffeine will have these symptoms. It is important that your healthcare providers know you are taking caffeine so that if symptoms occur your baby can get the care that is best for them.

Does consuming products with caffeine in pregnancy affect future behavior or learning for the child?

Most studies find no effect on learning or behavior in young school-aged children who were exposed to caffeine during pregnancy.

Breastfeeding while consuming products with caffeine:

Caffeine gets into breast milk in small amounts. It has been suggested to limit daily consumption to 300 mg/day or less while breastfeeding. If you suspect the baby has any symptoms (agitation, irritability, trouble with sleeping, rapid heart rate or tremor), contact the child’s healthcare provider. Be sure to talk to your healthcare provider about all your breastfeeding questions.

If men consume products with caffeine, could it affect fertility or increase the chance of birth defects?

Studies on caffeine and men’s fertility (ability to get a woman pregnant) have reported mixed findings. The American Society for Reproductive Medicine (ASRM) states that caffeine consumption has no effect on a semen. In general, exposures that fathers or sperm donors have are unlikely to increase risks to a pregnancy. For more information, please see the MotherToBaby fact sheet Paternal Exposures at https://mothertobaby.org/fact-sheets/paternal-exposures-pregnancy/.

Selected References:

• American College of Obstetricians and Gynecologists (ACOG). 2018. Moderate caffeine consumption during pregnancy. https://www​.acog.org​/Clinical-Guidance-and-Publications​/Committee-Opinions​/Committee-on-Obstetric-Practice​/Moderate-Caffeine-Consumption-During-Pregnancy?IsMobileSet=false.
• American Society for Reproductive Medicine (ASRM). 2022. Optimizing natural fertility: A Committee Opinion. https://www​.asrm.org​/practice-guidance/practice-committee-documents​/optimizing-natural-fertility-a-committee-opinion-2021/
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• CaffeineInformer. 2019. Caffeine in Guarana. https://www​.caffeineinformer​.com/caffeine-content/guarana. Accessed October 22, 2019.
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