Oh, that lovely cup of coffee! I honestly think one of the first things my pregnancy and breastfeeding clients ask me when we start working together is whether they can still have their cup of coffee.
I’m that kind of professional who likes to present arguments and help my clients make informed decisions. I’m a firm believer that once people understand why some things benefit them while others don’t, there’s a higher chance any resulting change will be more sustainable. So that’s why I put together a thorough blog post to help you make informed decisions with regards to coffee during pregnancy and postpartum – whether breastfeeding or not.
Coffee and bowel movements
Some women (and men) rely on their morning cup of coffee to go to the bathroom. While this is a habit that I strongly discourage, I understand why it can be scary to give up your coffee if you’ve become dependent on it for bowel movement.
Have you ever wondered why this happens though?
While coffee’s bioactive compounds and their numerous potential health-promoting properties have been extensively studied when it comes to the cardiovascular and central nervous system, the connection between coffee and the gastrointestinal tract has not received so much research attention so far. I find this very surprising considering that the gastrointestinal tract is the first body system that comes in contact with ingested coffee.
One study found that coffee “promotes the desire to defecate in at least one third of the population, predominantly women”. While I wasn’t able to find a research study that reveals how the entire process happens with a high accuracy, there are a few hypotheses that stand true.
- It’s not caffeine that is concerned with coffee’s effect on colon mobility since both regular and decaffeinated coffee can have a laxative effect.
- There are certain compounds contained in both caffeinated and decaffeinated coffee that influence the production of gastrin – a peptide hormone that promotes stomach contractions and relaxes the sphincters of the intestinal system, which can prompt a bowel movement.
- Some indirect effects of cholecystokinin (a peptide hormone of the gastrointestinal system responsible for stimulating the digestion of fat and protein) and motilin (that stimulates gastric and small intestine motility, causing undigested food in these regions to move into the large intestine), whose secretion is stimulated by coffee consumption, have also been mentioned in studies.
While this connection can be enchanting to some people, in my practice I focus on moving from coffee-dependent bowel movements to naturally stimulating our digestive system.
Coffee during pregnancy
Caffeine is one of the world’s most beloved stimulants and coffee is the most highly consumed across the world. It’s also present in black and green tea, cocoa, cola soft drinks and energy drinks. Sometimes you’ll find caffeine in chocolate bars, energy bars and some OTC medication, such as cough syrup or slimming tablets.
Results from studies on the effects of caffeine consumption in pregnancy have been mixed and are generally inconclusive, but what is generally accepted is the fact that caffeine is a stimulating, addictive alkaloid that reaches the bloodstream of the baby over the placenta. Also, caffeine has been detected in the amniotic fluid, umbilical cord, urine, and plasma of fetuses.
Unborn babies cannot break down caffeine, because a fetus’ liver doesn’t produce enough of the necessary enzymes. Caffeine is known to stimulate the nervous system of both mother and baby, but what’s less clear is how this affects a developing fetus.
Pregnant women metabolise caffeine at a slower rate than non-pregnant women, meaning they need 1.5 to 3.5 times longer to eliminate caffeine. The reason is the decreased activity of the liver enzyme responsible for caffeine metabolism. The body has plenty of other important tasks to focus on during these 9 months and some functions are deprioritised. Furthermore, a single cup of coffee has been shown to reduce iron absorption up to 39%, a mineral which is extremely important during pregnancy (and often deficient or at low levels).
Several studies reported an increased risk of misscariage and preterm birth if the mother consumes very large amounts of caffeine (about 8 cups of coffee a day or more). The amount of coffee (or caffeine, to be more precise) that’s considered “safe” during pregnancy varies across studies. That’s probably also the reason why recommendations regarding caffeine intake differ across different health organisations or countries. Some studies have found that reducing the consumption of caffeine to 180mg of caffeine (1 or 2 cups, depending on the cup size and coffee type) per day after 16 weeks of gestation was reported to cause no effect on birth weight. However, some have reported a lower dose than this.
“The risk for low birth weight was significantly higher even in the low (50 to149 mg/day) and moderate (150 to 349 mg/day) caffeine intake groups, as compared with the reference group with no or very low caffeine intake.”
The current World Health Organisation and Health Canada guidelines recommend a caffeine intake below 300 mg/day during pregnancy, while NHS mentions limiting consumption to no more than 200mg/day.
One large cup of coffee (around 250ml) contains between 100 – 200 mg of caffeine. This range varies depending on type of coffee, brewing method, preparation method, etc. The caffeine content will not decrease if you drink it with milk or if you add additional water. My recommendation is to aim for between 0 (ideal scenario) and 150mg a day. Pregnant women should not consume more than an upper level of 300 mg/day of caffeine.
Coffee during postpartum
It’s no brainer why the first thing mothers would choose to have in the morning is a ‘pick-me-up’ drink like coffee after a sleepless night. Yet there are a few drawbacks which you have to consider. Caffeine causes the adrenal glands to produce adrenaline and cortisol, two stress hormones that can leave mothers less capable of managing stress, which is generally counterproductive, but especially during the newborn phase.
Caffeine in excess has also been shown to reduce iron absorption, as already mentioned before, but also to leach calcium. And both minerals are essential during the postpartum period.
Caffeine is transferable through breast milk and some breastfed babies may be sensitive to caffeine. You can’t really know that unless you observe and notice signs such as baby being unusually fussy, overly alert and not staying asleep for long. These might be symptoms of other causes as well, so I know it can be difficult to conclude it’s from the cup of coffee you drank. But if baby is overly overstimulated, then I believe it’s worth trying to exclude coffee for a few days to see if there is any improvement.
When it comes to how much coffee one should consume during postpartum, my recommendation is the same as for pregnancy: aiming for 0-150 mg a day is ideal. And you could try drinking it right after you’ve breastfed.
What about decaffeinated coffee?
If you find it hard to give up the taste of coffee, decaffeinated coffee can be a nice supporting alternative. But most conventional brands use chemical solvents during the extraction processes, therefore I recommend finding a certified organic and / or swiss water decaffeinated coffee, since these ‘cleaner’ alternatives use carbon dioxide and water respectively.
On the other hand, decaffeinated coffee would still have a negative impact on the iron absorption, so if you suffer from low iron levels or anemia I would still recommend to avoid it. Also, the decaffeination process also influences the antioxidant content of coffee – which is actually one of the benefits of drinking coffee. Other great alternatives are turmeric latte (which I love) and matcha.
What alternatives to coffee did you opt for during pregnancy or postpartum?
Links to research studies:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7824117
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8778943
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6520888
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4507998
https://pubmed.ncbi.nlm.nih.gov/18221932
https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0132334
