Is caffiene really that big if a problem?

[24hourM0MMY]

I know that too much is defo a bad idea, but for those who have given up completely, did you have a doctor tell you to cut it out or was it a personal choice? I'm currently 6 weeks and I cannot for the life of me stop that first morning cup of coffee. The rest if the day, i have no problem staying away. Is it really linked to early misscarriages?

I see that now - well she certainly wanted to check my qualifications were to make such conclusions (although as stated it is a theory)

As your claim is in line with my theory I am inclined to believe you, although of course taking into account that these may be few cases and may not be true of all caffeine addicts.

Spot on Elsa. Thanks.
I am a bit crap at explaining myself sometimes.

Interested to see your experiences with caffeine in a preterm Bedafterdark. Do you know what doses your DD was on? Only as I am interested in what would be considered a large dose in a 2lb baby, and wonder how that equates to the consumption in a pregnant mother (bearing in mind that not all the caffeine ingested by the mother will pass through the placenta). Just as I am interested- certainly not disputing, as you say, your DD does sound like she would have been a prime candidate for caffeine withdrawal.

But surely practising hcps have a duty to evidence in a non emotive way and avoid hypothesis/theory?

I'm not entirely sure what you are giving up Lily. I'm just saying that you need to be careful of the wording that you use. How do you quantify the difference between a 'big' and a 'small' problem?

All that was needed though, in the context of a thread likely to be read by anxious pregnant women was the clarification that your theories are about caffeine addicts on their 5 cups a day/1000mg.

That is all the rest of us are saying.

Otherwise women well within the 200mg "limit" who are incredibly unlikely to have triggered preterm labour or have an addicted baby will freak out ... especially if they're further along.

Moving the conversation away from miscarriage and on to newborns suffering withdrawal isn't really a step forward. Imo.

Lilliput I for one appreciate the information you have shared, i have pretty much steered away from caffeine and although I love my coffee and cola, I am managing just fine without them! I think some of the people just wanted to nitpick for no good reason

"No good reason"

...If a woman who has a premature baby (common) stumbles upon this thread and thinks her below - guidelines caffeine intake did it, and it makes her feel awful?
...If a woman who has followed the nhs guidance to the letter with 1 cup of tea a day, is at 36 weeks reads this and fears she'll birth an addict?

Are their feelings "no good reason"? Bearing in mind they've done nothing wrong or harmful (everyone is actually agreed on that: the problems start at 1000mg per day).

Thanks for that Tori. I wonder what percentage of ingested caffeine ends up passing through into the placenta and into the unborn foetus to cause addiction, and how much that would equate to with an individual consuming 200mg a day, being greater or less than the 5mg/kg.

For others that have suggested she was, Liliput's was not scaremongering anyone. She was simply saying that the baby may be addicted when born if subjected to large amounts caffeine, and that is going to result in a crabby, difficult to settle baby. Rather than attack her for this, you could have asked her a simple question, how much caffeine would you suggest that is? And she would have been able to give you an answer.

She was actually bringing the conversation away from the scaremongering of blaming miscarriages on caffeine consumption, and bringing up,what I believe to be a valid point as I am referring addiction to caffeine consumption for the entirety of the development of the foetus.

Elsas with all due respect the quantity more or less had to be prized out of her and the report. People did ask!

The tone, with scary adjectives, was very much the issue.

If that kind of thing happened face to face in a hcp scenario, would you expect the patient to have to ask? Because many wouldn't. They'd walk out of there absolutely shit scared or wracked with guilt.

squizita I find you rather aggressive! Calm down, it's a discussion. Not an argument!

Elsa well said??

It's not just an argument in a vacuum though. It's something that can be and will be read by worried pregnant women.

Anyone who knows this board would surely know that?

I'm not sugar coating my examples. I'm simply giving scenarios and issues based on knowing how the traffic on MN medical boards tends to behave.
I'm sorry if you find that aggressive.

Honestly I am not trying to make anyone feel bad or look bad.

However it is likely people finding this thread will worry or feel guilty.

When we lay out risk, it is the responsible thing to do to include - openly and clearly - as much factual and helpful info as we can.
Otherwise it's scaring people without offering support.

hot drinks make me sick at the moment but diet coke makes me feel a bit better and I am having lots of chocolate. When my coffee taste comes back I will probs restrict myself to one tea and one coffee or coke per day

Ok so I just had a moment to look at the study Lilliput said that midwives refer to.

Of it's own research, it states that there is insufficient evidence to evaluate the effect of caffeine on fetal, neonatal and maternal outcomes. It was looking at birthweight, first trimester miscarriage, preterm birth, stillbirth or cot death, heart problems, cerebral palsy and cognitive impairment.

However it refers to other studies in the discussion;

Excessive maternal caffeine consumption (more than eight cups per day) may result in increased ...[risk of] utero-placental vasoconstriction [a leading cause of still birth], increased fetal heart rate and arrhythmias (irregularity of heart rate)... and, as a consequence, lack of fetal oxygenation.

A recent study suggests caffeine impaired insulin sensitivity in women with GDM [gestational diabetes]. Thus, it is theoretically plausible that these effects could adversely affect the pregnancy and increase the risk of miscarriage .. ; low birthweight..; stillbirth...; and sudden infant death syndrome ....

The Rondo study suggested that the proportion of mothers who delivered growth restricted babies increased as the average consumption of coffee increased....

Moreover, neonatal withdrawal symptoms have been observed as a result of high levels of maternal caffeine intake.

they did not quantify what these high levels of caffeine were and I have been unable to see anything but the abstract of that paper that states;

We have identified eight infants born to mothers who were heavy users of caffeine during pregnancy. These infants exhibited unusual behavior in the immediate newborn period. Predominant symptoms were irritability, jitteriness, and vomiting. The eight infants had extensive diagnostic studies and none of the usual causes for their symptoms were identified. Caffeine was present in the serum of six infants, and three of the six infants had caffeine in their urine. The symptoms resolved spontaneously. We hypothesize that these infants were exposed to high maternal levels of caffeine for the majority of the pregnancy, resulting in a withdrawal syndrome after delivery.

This is only an observation of eight infants and who is to say that milder cases are not more prevalent but undocumented?

I was extremely interested to read in Liliput's study that;

Moreover, clearance of caffeine from the mother's blood slows down during pregnancy and its half life [length of time to break down] is tripled during the second and third trimester.... , while the fetus is lacking a sufficient amount of the enzyme needed to metabolise it [break it down].

Which means there could be a real build-up of caffeine in a foetus's blood, and support the concept of foetal addiction to caffeine.

The study points out;

Animal studies have shown that chronic caffeine exposure during pregnancy .... makes[sic] the brain and other tissues vulnerable to the harmful effect of caffeine because there is no..... placental barrier to caffeine.

I find this incredibly interesting and feel that it serves to back up my earlier mentioned theory.

In contrast the all of the above, the study does point out;

However, other investigators have failed to find any association between caffeine intake and poor pregnancy outcomes. Wen 2001 showed that pregnant women who were taking coffee before pregnancy had fewer incidents of spontaneous miscarriage... Clausson ...showed that there was no association between caffeine consumption and birthweight, gestational age and birthweight ratio. Another large prospective study of 2291 mothers also showed that caffeine consumption in the first and third trimesters was not associated with intrauterine growth restriction, low birthweight or preterm delivery ...

Beneficial effects of caffeine intake during pregnancy are reported in some other studies. Moderate prepregnancy coffee consumption may have a protective association with GDM. It has been found that the consumption of coffee increases ventilatory frequency in the general population.... A study on rats suggests that caffeine....may prevent respiratory disturbances... Moreover, the beneficial effect of caffeine has been shown in neonatal rodents. Caffeine as an adenosine antagonist may prevent brain injures due to lack of oxygen. Therefore, it is postulated that caffeine administration during early postnatal development may prevent brain injury, which is the most common cause of cerebral palsy and cognitive impairment in premature infants (Back 2006). I now see why it is given to preterms as discussed upthread.

in the end, the paper says:

Conflicting results found in the literature make it difficult for health professionals to advise pregnant women about avoiding caffeine during pregnancy. The objective of this review, therefore, is to assess the impact of avoidance of maternal consumption of caffeine on pregnancy outcome.

Which is why we are all in such a muddle about the whole thing anyway. So go with what you feel is right, but go armed with the knowledge that the research just isn't conclusive

squizita if people are scared even though the NHS guidelines say up to 200 mg a day is fine, then they are just paranoid. Taking Mumsnet users advice over medical guidance is simply foolish.

My personal opinion is that a normal amount of tea/coffee is fine. Chemical-laden soft drinks like Coke, Red Bull - not healthy whether pregnant or not, and probably a good idea to drop while pregnant for many reasons beyond caffeine or miscarriage fears alone.

Newbain have you rtwt? There is a mw who ominously tells her patients caffeine causes "big problrms" and babies are born addicted. It took several people to extract how rare thus is.

There are many women who are "paranoid" as you put it ... ftm, women pregnant after loss or if especially.
It is not rare. It is common. It is understandable.

Have some basic human empathy ffs.

Elsa exactly.

But don't be a hcp who goes and warns all her patients that their 1 cup a day can cause "big" problems based on inconclusive evidence.
Say there is some evidence high amounts may cause issues.

Quit attacking her! She did not say that. She said;

As a midwife I have seen newborn babies withdrawing from mums heavy caffeine consumption. Think about you would feel going totally cold turkey from caffeine? Headache, cranky, jittery. All makes for a very unsettled newborn.

When asked what heavy useage was, she said i think the recommended amount is 200mg, but I might be wrong.

The recommended amount is there because there is no evidence to prove that consumption below this level can be harmful but this is extremely difficult, if not impossible to quantify. As we see from the study I deciphered above, caffeine builds up in the body of the pregnant mother over the 2nd and 3rd trimesters so actually even a mother sticking to the recommended levels could cause some level of discomfort to the baby when born, we just have not proved this either way. The fact is,the phenomenon of neonatal caffeine withdrawal does exist but have not been able to state a level at which this becomes a particular risk.

However we have ascertained that in order for a baby to be more at risk of miscarriage, low birth weight etc, the mother would be drinking 5 times the recommended amount. In fact it has been suggested that caffeine drunk by a pre-pregnant mother helps against gestational diabetes in pregnancy.

I'm really glad I've looked into this in more detail. And having done so, I'm really glad I went cold turkey on caffeine. I never had the slightest fear of low birth weights as my babies were huge -nothing to do whatsoever with my lack of caffeine consumption (genetics were playing their hand in that, my DCS are v tall). I also miscarried once, and that had nothing to do with caffeine consumption or lack of it. But again I stand by the theory that the baby might get addicted (in fact I believe this even more so now that I have looked into this). Lilliput was just highlighting the same possibility as me.

But Elsa everyone was talking about probably 3 caffeinated drinks maximum. Had someone come on saying they have 8 cups of coffee a day then advising them of the effect it can have on the baby would be acceptable, but she decided to post links rather than her own experiences as we all asked

I didn't give up. There is no way I could have. Pregnancy made me so tired and there were already so many things I was struggling to quit!

I did recently see some statistics regarding caffeine during pregnancy and childhood leukemia that made for pretty scary reading though.

I stepped away from this thread yesterday because I didn't want an argument. However Squizita is spot on in my opinion. The op's question was whether one cup of coffee is a problem. The answer is quite clearly no and the answers to the thread are quite simply not relevant in many cases. That isn't attacking anyone, it is simply stating fact. Had the op been 'I am drinking 10 cans of redbull a day' then the replies would have been proportionate, correct and relevant.

I disagree that the answer is quite clearly no. It depends what you define as 'a problem'. We have ascertained that low birth weight etc are not a risk unless the mother is on eight cups a day, but we haven't managed to eliminate the possibility that addiction in newborns could exist at lower levels, even after doing a bit of research.

That is not to say that mild cases of addiction are damaging to the baby. I very much doubt they are. It just adds to the discomfort of leaving that lovely warm watery world of the womb.

The same report that called 8 cups a day 'excessive', used the milder term 'heavy' for the consumption of the mothers whose babies demonstrated extreme withdrawal symptoms from caffeine.

As such a thing as newborn addiction to caffeine has been proven, how are we to know that it does not exist in milder amounts when lower amounts of caffeine are consumed?

After all, there are a lot of us feeding our caffeine addiction as adults on just one or two cups a day. I normally only have two cups of coffee a day but I am most definitely addicted. Just think, if only a tiny percentage of that caffeine gets into the foetus, which as we have seen builds up as the enzyme required to break it down is not present, then in my mind there's a pretty good chance the baby will be addicted too. Even on two cups a day.

Lilliput was asked why isn't caffeine intake asked about as much - I would say that's because this phenomenon of newborn caffeine withdrawal isn't well enough documented or researched, certainly not in comparison to alcohol intake, and I'd propose that that's probably because milder cases are just so difficult (or perhaps impossible) to prove- and possibly midwives are not all aware of it.

Lilliput did relate her own experiences as a midwife and people were not happy with that so she gave links to back herself up

I for one would have been happy to be made aware of the possibility of newborn caffeine withdrawal when pregnant. We just don't know whether withdrawal from two or three caffeinated drinks a day causes any discomfort to the baby when it is born. Whether it does or not, all I did was remove that possibility. After all, less cranky babies generally sleep better, so being made aware allows someone to simply weigh up the advantage of getting more sleep after giving birth, over the benefit of being more alert during pregnancy. Surely it is better to be aware of such things?